Provider Information for 1649300146
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Mrs. KARLA J BURGESS LMHP, LPC
Sex: Female
NPI: 1649300146
Last Updated: 2008-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1649300146 | ||||||||||||||||
| Enumeration Date | 2007-03-06 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | PO BOX 465 RED CLOUD, NE 68970-0465 United States Phone: 402-746-5614 | Fax:402-746-5684 | ||||||||||||||||
| Primary Practice Address | 721 W 6TH AVE RED CLOUD, NE 68970-2278 United States Phone: 402-746-5614 | Fax:402-746-5684 | ||||||||||||||||
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