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General NPI Number Information
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NPI Number | 1619270311
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Entity Type | Individual
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Provider Name | GAVETT BURCH M.A.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2010
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Last Update Date | 08/11/2018
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Provider Practice Location Address
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Address Line | 222 W GREGORY BLVD. SUITE #319
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City | KANSAS CITY
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State | MO
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Zip | 64114
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Country | US
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Telephone | 816-834-9494
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Fax | 816-817-1699
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Provider Business Mailing Address
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Address Line | 222 W GREGORY BLVD. SUITE #319
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City | KANSAS CITY
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State | MO
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Zip | 64114-1140
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Country | US
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Telephone | 816-834-9494
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Fax | 816-817-1699
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 77579
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2014009429
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License Number State | MO
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