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Individual
GEORGIA KNICKERBOCKER BURKHARDT
Active
Individual
GEORGIA KNICKERBOCKER BURKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
013040
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P108244
LIMITED PERMIT
NY
Enumeration date
03/18/2021
Last updated
08/25/2025
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