Individual
MRS. KATHLEEN SUE BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
138 WASHINGTON, MONTROSE, MI 48457-7719
(810) 639-4520
Mailing address
138 WASHINGTON, P.O. BOX 575, MONTROSE, MI 48457-7719
(810) 639-4520
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AF 250247793
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9182961
—
MI
Enumeration date
10/08/2008
Last updated
10/08/2008
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