Provider Demographics
NPI:1720289846
Name:KIRKLEY, DALE EMERSON (MA)
Entity type:Individual
Prefix:MR
First Name:DALE
Middle Name:EMERSON
Last Name:KIRKLEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:180 MAPLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8691
Mailing Address - Country:US
Mailing Address - Phone:828-265-0922
Mailing Address - Fax:828-262-3182
Practice Address - Street 1:614 HOWARD ST
Practice Address - Street 2:STUDENT WELLNESS CENTER ASU
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6244
Practice Address - Country:US
Practice Address - Phone:828-262-3148
Practice Address - Fax:828-262-3182
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional