| NPI | 1558441931 |
|---|---|
| Former Name | GEORGIANA G BURKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC 10240) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IA 00852) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2012-01-24 |