Provider Information for 1487349064
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Mrs. MICHELLE OLIPHANT BURNS LPC
Sex: Female
NPI: 1487349064
Last Updated: 2024-06-26
Certification Date: 2024-06-26
Certification Date: 2024-06-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1487349064 | ||||||||
| Enumeration Date | 2023-04-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2011 CANTON DR NORTH AUGUSTA, SC 29841-9258 United States Phone: 803-634-7977 | Fax: | ||||||||
| Primary Practice Address | 1202 TOWN PARK LN STE 300 EVANS, GA 30809-3477 United States Phone: 770-389-8100 | Fax: | ||||||||
| Secondary Practice Address(es) | 2011 CANTON DR | ||||||||
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