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General NPI Number Information
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NPI Number | 1508487158
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Entity Type | Individual
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Provider Name | EMILY ANN BURKS LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 5040 N 15TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85015-3328
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Country | US
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Telephone | 602-234-7174
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Fax |
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Provider Business Mailing Address
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Address Line | 5040 N 15TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85015-3328
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Country | US
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Telephone | 602-234-7174
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 65995
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-17738
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License Number State | AZ
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