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Individual

BRIAN JAY BURGENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
9403 ODYSSEY CT, BURKE, VA 22015-1910
(703) 426-0499
Mailing address
9403 ODYSSEY CT, BURKE, VA 22015-1910
(703) 426-0499

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC 10076
NJ

Other

Enumeration date
05/19/2008
Last updated
05/19/2008
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