| Doctor Name: | ANGELA M BURLOCK |
| NPI Number: | 1417283375 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-CC |
| License Number: | MC12102 |
| Business Practice Address: | 18 High St Houlton, ME - 047302013 |
| Business Phone Number: | 2075329660 |
| Business Fax Number: | 2075329640 |
| Mailing Address: | Po Box 509, PRESQUE ISLE |
| State: | ME |
| Postal Code: | 047690509 |
| Phone Number: | 2077646825 |
| Fax Number: | 2077646077 |
| NPI Enumeration Date: | 10/28/2009 |
| NPI Last Update Date: | 10/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | MC12102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |