Provider Information for 1679030894
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
REBECCA J BURDA LCSW
Sex: Female
NPI: 1679030894
Last Updated: 2024-09-13
Certification Date: 2024-09-13
Certification Date: 2024-09-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1679030894 | ||||||||
| Enumeration Date | 2019-02-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3251 GRAYDON AVE EAST TROY, WI 53120-1175 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 101 W EVERGREEN PKWY ELKHORN, WI 53121-4095 United States Phone: 414-325-7741 | Fax: | ||||||||
| Secondary Practice Address(es) | 739 MEADOW CT | ||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|