| Doctor Name: | JENNIFER BURDSALL |
| NPI Number: | 1033419411 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PCC |
| License Number: | E-0800155 |
| Business Practice Address: | 101 E Park Dr Albion, IN - 467011438 |
| Business Phone Number: | 2606366884 |
| Business Fax Number: | 2606363392 |
| Mailing Address: | 850 N Harrison St, WARSAW |
| State: | IN |
| Postal Code: | 465803163 |
| Phone Number: | 5742677169 |
| Fax Number: | 5742695573 |
| NPI Enumeration Date: | 11/01/2010 |
| NPI Last Update Date: | 07/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | E-0800155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |