| Doctor Name: | MS. JEANNIE S BURDICK |
| NPI Number: | 1902917933 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. CLINICAL PSYCH |
| License Number: | 001111-1 |
| Business Practice Address: | 8801 Boyce Rd Corfu, NY - 140369742 |
| Business Phone Number: | 5853430055 |
| Business Fax Number: | |
| Mailing Address: | 8801 Boyce Rd, CORFU |
| State: | NY |
| Postal Code: | 140369742 |
| Phone Number: | 5853430055 |
| Fax Number: | |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 001111-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |