Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | PE11708 | TN |
Y | 103TH0100X | Health Service | 11708 | TN |
NPI | 1245356799 |
---|---|
Provider Name | Joelle S. Burkett |
First Address | Knoxville, TN 37917-5158 |
Second Address | Knoxville, TN 37921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 09/10/2018 |