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General NPI Number Information
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NPI Number | 1801237300
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Entity Type | Individual
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Provider Name | RUSSELL P.D. BURTON PH.D. LMSW
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Gender | Male
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 236 NW KNOX AVE
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City | TOPEKA
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State | KS
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Zip | 66606-1340
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Country | US
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Telephone | 785-845-6872
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Fax |
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Provider Business Mailing Address
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Address Line | 236 NW KNOX AVE
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City | TOPEKA
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State | KS
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Zip | 66606-1340
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Country | US
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Telephone | 785-845-6872
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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 | LMSW 8904
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License Number State | KS
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