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NPI Code Detail

MEDICARE: EBONE BURTON

MEDICARE: EBONE BURTON
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
1106S00000XBehavior TechnicianAZ

General Provider Information

NPI Number : 1831021013
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONE BURTON
Provider Business Mailing Address
First Line : 17235 N 75TH AVE STE G120
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-0895
Country : US
Telephone Number : 480-812-4789
Fax Number :
Provider Business Practice Location Address
First Line : 17235 N 75TH AVE STE G120
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-0895
Country : US
Telephone Number : 480-812-4748
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ EBONE BURTON ” Practice Location

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