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General NPI Number Information
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NPI Number | 1386060945
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Entity Type | Organization
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Legal Business Name | RUTH BURNETT
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 5613 DURALEIGH RD STE 161
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City | RALEIGH
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State | NC
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Zip | 27612-2709
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Country | US
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Telephone | 919-622-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 100 QUID CT
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City | CARY
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State | NC
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Zip | 27513-4848
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Country | US
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Telephone | 919-622-0005
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | RUTH ANNE BURNETT
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Credential | LPC
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Telephone | 919-622-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8638
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License Number State | NC
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