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General NPI Number Information
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NPI Number | 1164167813
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Entity Type | Individual
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Provider Name | TERRY D BURGER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 110 E MARKET ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-3410
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Country | US
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Telephone | 812-946-6411
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Fax | 812-725-8559
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Provider Business Mailing Address
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Address Line | 28 ARBOR PL
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City | NEW ALBANY
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State | IN
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Zip | 47150-7292
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Country | US
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Telephone | 859-298-8955
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Fax | 812-725-8559
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1420551
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License Number State | IN
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