Doctor Name: | MR. MICHAEL R BURPEE |
NPI Number: | 1912097262 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LW00005633 |
Business Practice Address: | 7329 11th St Bld 547 Hill Afb, UT - 840565012 |
Business Phone Number: | 8017773497 |
Business Fax Number: | |
Mailing Address: | 3350 S. 550 W., SYRACUSE |
State: | UT |
Postal Code: | 84075 |
Phone Number: | 8014443528 |
Fax Number: | |
NPI Enumeration Date: | 10/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LW00005633 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |