Doctor Name: | DR. DANNY BURNSIDE |
NPI Number: | 1093023160 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.DIV., M.A. PH. D. |
License Number: | |
Business Practice Address: | 272 Heather Glen Dr Boiling Springs, SC - 293165939 |
Business Phone Number: | 8642662291 |
Business Fax Number: | |
Mailing Address: | 272 Heather Glen Dr, BOILING SPRINGS |
State: | SC |
Postal Code: | 293165939 |
Phone Number: | 8642662291 |
Fax Number: | |
NPI Enumeration Date: | 09/22/2010 |
NPI Last Update Date: | 12/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |