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General NPI Number Information
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NPI Number | 1457534943
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Entity Type | Organization
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Legal Business Name | SUZANNE D. BURTON
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 330 CEDAR RD
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City | HERSHEY
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State | PA
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Zip | 17033-9302
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Country | US
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Telephone | 717-534-2076
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Fax | 415-534-2073
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Provider Business Mailing Address
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Address Line | 330 CEDAR RD
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City | HERSHEY
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State | PA
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Zip | 17033-9302
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Country | US
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Telephone | 717-534-2076
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Fax | 415-534-2073
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. SUZANNE DAWN BURTON
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Credential | LPC
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Telephone | 717-534-2076
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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 | PC002629
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License Number State | PA
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