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NPI Code Detail

MEDICARE: IRENE BURKE M.A.

MEDICARE: IRENE BURKE M.A.
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
1101YM0800XMental Health CounselorIN

General Provider Information

NPI Number : 1346536570
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE BURKE M.A.
Provider Business Mailing Address
First Line : 4180 S PECOS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5074
Country : US
Telephone Number : 702-486-7593
Fax Number : 702-486-7576
Provider Business Practice Location Address
First Line : 4180 S PECOS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5074
Country : US
Telephone Number : 702-486-7593
Fax Number : 702-486-7576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2011
Last Update Date : 06/27/2011

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