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Individual
MRS. JILLYN KNEELAND BURK
Active
Individual
MRS. JILLYN KNEELAND BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6935666-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000065887
PTAN
UT
Enumeration date
05/08/2008
Last updated
05/01/2015
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