Individual
MISS HEATHER AMY BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLAC
Contact information
Practice address
212 N HILLSIDE ST, WICHITA, KS 67214-4935
(316) 558-3066
Mailing address
212 N HILLSIDE ST, WICHITA, KS 67214-4935
(316) 558-3066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1450
KS
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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