Individual
MRS. MICHELLE MARIE BURKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC LPC
Contact information
Practice address
1500 E HERITAGE PARK ST STE 150, MERIDIAN, ID 83646-5800
(082) 631-0843
(208) 906-0807
Mailing address
1500 E HERITAGE PARK ST STE 150, MERIDIAN, ID 83646-5800
(082) 631-0843
(208) 906-0807
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC6211
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245500826
—
ID
Enumeration date
01/12/2012
Last updated
09/04/2019
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