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General NPI Number Information
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NPI Number | 1124490362
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Entity Type | Organization
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Legal Business Name | BRYNN ROGERS BURNS
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 5900 N BURDICK ST STE 102A
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-9477
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Country | US
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Telephone | 315-400-2483
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Fax |
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Provider Business Mailing Address
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Address Line | 3 DRUMLINS TER
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City | SYRACUSE
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State | NY
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Zip | 13224-2217
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Country | US
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Telephone | 315-400-2483
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPY
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Name | BRYNN ROGERS BURNS
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Credential | MFT
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Telephone | 315-400-2483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 06001266
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License Number State | NY
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