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General NPI Number Information
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NPI Number | 1447862172
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Entity Type | Organization
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Legal Business Name | DR BURWELL SPEAKS, LLC
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 3495 BUCKHEAD LOOP NE STE 1112
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City | ATLANTA
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State | GA
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Zip | 30326-1528
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Country | US
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Telephone | 919-800-7629
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19358
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City | ATLANTA
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State | GA
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Zip | 31126-1358
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Country | US
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Telephone | 919-800-7629
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRYSTAL BURWELL
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Credential | LPC
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Telephone | 919-800-7629
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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 |
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License Number State |
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