Doctor Name: | DONNA KAY BURGESON |
NPI Number: | 1023350824 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLPC |
License Number: | 2013007073 |
Business Practice Address: | 509 W Rollins Suite 207 Moberly, MO - 652701550 |
Business Phone Number: | 6602699200 |
Business Fax Number: | |
Mailing Address: | 509 W Rollins, Suite 207 MOBERLY |
State: | MO |
Postal Code: | 652701550 |
Phone Number: | 6602699200 |
Fax Number: | 6602699200 |
NPI Enumeration Date: | 03/20/2013 |
NPI Last Update Date: | 10/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2013007073 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |