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NPI Code Detail

MEDICARE: DR. STEVEN BURGGRAF PH.D

MEDICARE: DR. STEVEN BURGGRAF PH.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorE. 0002169OH

General Provider Information

NPI Number : 1225252174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN BURGGRAF PH.D
Provider Business Mailing Address
First Line : 151 MARION AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-2223
Country : US
Telephone Number : 419-774-9969
Fax Number :
Provider Business Practice Location Address
First Line : 151 MARION AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-2223
Country : US
Telephone Number : 419-774-9969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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