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General NPI Number Information
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NPI Number | 1346052016
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Entity Type | Individual
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Provider Name | MICHAEL ALEXANDER BURROW
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Gender | Male
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 432 MOULTON ST E
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City | DECATUR
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State | AL
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Zip | 35601-3002
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Country | US
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Telephone | 256-542-1482
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 663
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City | ATHENS
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State | AL
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Zip | 35612-0663
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Country | US
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Telephone | 205-617-0435
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ALC04195
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License Number State | AL
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