Provider Information for 1881979607
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JACQUELYN M BURNS PCC
Sex: Female
NPI: 1881979607
Last Updated: 2011-10-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1881979607 | ||||||||||||||||
| Enumeration Date | 2011-10-12 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 346 HICKORY LN DELAWARE, OH 43015-1008 United States Phone: 614-296-6321 | Fax: | ||||||||||||||||
| Primary Practice Address | 346 HICKORY LN DELAWARE, OH 43015-1008 United States Phone: 614-296-6321 | Fax: | ||||||||||||||||
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