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General NPI Number Information
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NPI Number | 1639944309
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Entity Type | Individual
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Provider Name | LORI T BURNETT LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 706 W BEN WHITE BLVD STE 184
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City | AUSTIN
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State | TX
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Zip | 78704-8124
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Country | US
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Telephone | 512-591-8358
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 WARWICK WAY
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City | AUSTIN
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State | TX
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Zip | 78748-2023
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Country | US
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Telephone | 512-944-4718
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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 | 56971
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License Number State | TX
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