Individual
KELLI ANNE BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
221 ACORN ST, RINCON, GA 31326-8823
(912) 661-6151
Mailing address
221 ACORN ST, RINCON, GA 31326-8823
(912) 661-6151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7800
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7800
LICENSE NUMBER
SC
Enumeration date
08/31/2016
Last updated
07/03/2023
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