Individual
IRA BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
875 MS-475, PEARL, MS 39208
(601) 664-6000
Mailing address
5330 N STATE ST LOT 118, JACKSON, MS 39206-3458
(601) 937-9774
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
011707001029
MS
Other
Enumeration date
07/24/2026
Last updated
07/24/2026
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