Individual
PETER BURNHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
127 S 5TH AVE, TUCSON, AZ 85701-2005
(520) 327-4505
(520) 202-1889
Mailing address
127 S 5TH AVE, TUCSON, AZ 85701-2005
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LISW - 1844
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
755100
—
AZ
Enumeration date
06/18/2006
Last updated
07/09/2007
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