Doctor Name: | AMY BURNSIDE |
NPI Number: | 1003164187 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 3910 S Rural Rd Suite J Tempe, AZ - 852825581 |
Business Phone Number: | 4803179868 |
Business Fax Number: | 4803179867 |
Mailing Address: | 3910 S Rural Rd, Suite J TEMPE |
State: | AZ |
Postal Code: | 852825581 |
Phone Number: | 4803179868 |
Fax Number: | 4803179867 |
NPI Enumeration Date: | 08/21/2012 |
NPI Last Update Date: | 08/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |