Individual
NICOLE BURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 NW 1ST ST, GAINESVILLE, FL 32601-5343
(866) 427-5451
Mailing address
2400 S RIDGEWOOD AVE STE 32, SOUTH DAYTONA, FL 32119-3073
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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