Doctor Name: | JAMES K BURKE |
NPI Number: | 1295799310 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 0715 |
Business Practice Address: | 1460 N Dixie Blvd Ste B Radcliff, KY - 401601476 |
Business Phone Number: | 2703515505 |
Business Fax Number: | 2703515504 |
Mailing Address: | 1460 N Dixie Blvd Ste B, RADCLIFF |
State: | KY |
Postal Code: | 401601476 |
Phone Number: | 2703515505 |
Fax Number: | 2703515504 |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 09/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0715 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |