Individual
JASON BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSED, MA
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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