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1720055304
JEFFREY W BURNETT
SOUTH BEND, IN
NPI
1720055304
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TB0200X Psychologist, Cognitive & Behavioral
(Licence: IN 20041003A)
Enumeration Date
2006-03-02
Last Update Date
2008-12-10
Business Address
-- JEFFREY W BURNETT HSPP
611 LINCOLN WAY E
SOUTH BEND, IN 46601-3220
Phone number: 574-232-2255
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Mailing Address
-- JEFFREY W BURNETT HSPP
611 LINCOLN WAY E
SOUTH BEND, IN 46601-3220
Phone number: 574-232-2255
Copy
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