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General NPI Number Information
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NPI Number | 1700927407
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Entity Type | Individual
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Provider Name | CHRISTINE M BURRELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 2386 CLOWER ST BLDG C, SUITE 100
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City | SNELLVILLE
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State | GA
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Zip | 30078-6134
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Country | US
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Telephone | 770-985-2050
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Fax | 770-985-2050
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Provider Business Mailing Address
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Address Line | 2386 CLOWER ST BLDG C, SUITE 100
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City | SNELLVILLE
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State | GA
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Zip | 30078-6134
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Country | US
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Telephone | 770-985-2050
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Fax | 770-985-2050
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW002958
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License Number State | GA
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