MEDICARE: MS. REBECCA A BURKLEY M.S,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1023281672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA A BURKLEY M.S,

Provider Business Mailing Address
First Line	:	1011 BINGHAM STREET 4TH FLOOR
Second Line	:	WPIC - EARLY INTENSIVE BEHAVIOR INTERVENTION PROGRAM
City	:	PITTSBURGH
State	:	PA
Zip	:	15203
Country	:	US
Telephone Number	:	412-235-5326
Fax Number	:	412-235-5387

Provider Business Practice Location Address
First Line	:	1011 BINGHAM STREET 4TH FLOOR
Second Line	:	WPIC - EARLY INTENSIVE BEHAVIOR INTERVENTION PROGRAM
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1101
Country	:	US
Telephone Number	:	412-235-5326
Fax Number	:	412-235-5387

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	04/03/2008

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