| Doctor Name: | THERESA MARIE BURKE |
| NPI Number: | 1073819298 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, PH.D., LPC, NCP. |
| License Number: | PC000408 |
| Business Practice Address: | 743 Roy Rd King Of Prussia, PA - 194061959 |
| Business Phone Number: | 6103540555 |
| Business Fax Number: | 6103540311 |
| Mailing Address: | 743 Roy Rd, KING OF PRUSSIA |
| State: | PA |
| Postal Code: | 194061959 |
| Phone Number: | 6103540555 |
| Fax Number: | 6103540311 |
| NPI Enumeration Date: | 02/04/2011 |
| NPI Last Update Date: | 03/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC000408 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |