Provider Information for 1396982369
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STEPHEN JASON BURKE MSW LICSW
Sex: Male
NPI: 1396982369
Last Updated: 2016-12-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1396982369 | ||||||||||||
| Enumeration Date | 2009-01-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 466 RAYMOND, NH 03077-0466 United States Phone: 603-502-4994 | Fax: | ||||||||||||
| Primary Practice Address | 50 NASHUA RD SUITE 301 LONDONDERRY, NH 03053-3400 United States Phone: 603-502-4994 | Fax: | ||||||||||||
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