Individual
CAROL JEAN BURKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
2301 RIVERSIDE DR, SUITE 8, GREEN BAY, WI 54301-1907
(920) 430-9100
(920) 430-9101
Mailing address
2301 RIVERSIDE DR, SUITE 8, GREEN BAY, WI 54301-1907
(920) 430-9100
(920) 430-9101
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2997-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43583600
—
WI
Enumeration date
03/13/2007
Last updated
07/08/2007
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