Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 43 | AK |
NPI | 1003012147 |
---|---|
Provider Name | Ms. Sheila Mary Burke |
First Address | Eagle River, AK 99577-7903 |
Second Address | Eagle River, AK 99577-8079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 08/07/2007 |