Individual
MARY JO BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, APRN, BC-PMH
Contact information
Practice address
110 E CHESTNUT ST, ROME, NY 13440-2832
(315) 339-3597
(315) 339-1844
Mailing address
110 E CHESTNUT ST, ROME, NY 13440-2832
(315) 339-3597
(315) 339-1844
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
RN158632NY
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121197
VALUE OPTIONS
NY
01
—
3191621
GHI
NY
Enumeration date
12/18/2006
Last updated
07/08/2007
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