MEDICARE: ALISON H. BURTON LMFT78877

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	106H00000X	Marriage & Family Therapist	LMFT78877	CA

General Provider Information

NPI Number	:	1184968083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON H. BURTON LMFT78877

Provider Business Mailing Address
First Line	:	537 S CALLE ABRONIA APT 3
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92264-7495
Country	:	US
Telephone Number	:	760-567-3212
Fax Number	:

Provider Business Practice Location Address
First Line	:	537 S CALLE ABRONIA APT 3
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92264-7495
Country	:	US
Telephone Number	:	760-567-3212
Fax Number	:

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

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	07/19/2014

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