| Doctor Name: | MS. MALLORY HELEN BURNETT |
| NPI Number: | 1144558156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. LPCC |
| License Number: | T-0127561 |
| Business Practice Address: | 2469 Corrales Road N.w. Corrales, NM - 870487530 |
| Business Phone Number: | 5057179552 |
| Business Fax Number: | 5053691121 |
| Mailing Address: | 47 Desert Willow Rd, CORRALES |
| State: | NM |
| Postal Code: | 870487530 |
| Phone Number: | 5057179552 |
| Fax Number: | 5053691121 |
| NPI Enumeration Date: | 12/02/2009 |
| NPI Last Update Date: | 03/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | T-0127561 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |