Provider Demographics
NPI:1427647759
Name:LUNA, KIRBY (MA, LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KIRBY
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:MA, LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 VELA RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-2527
Mailing Address - Country:US
Mailing Address - Phone:979-292-5641
Mailing Address - Fax:
Practice Address - Street 1:2219 SAWDUST RD STE 1003
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2580
Practice Address - Country:US
Practice Address - Phone:281-719-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist