Individual
DIANNA ELIZABETH BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.C.
Contact information
Practice address
129 N PEARL ST, COVINGTON, OH 45318-1611
(937) 573-6051
(937) 473-3184
Mailing address
129 N PEARL ST, COVINGTON, OH 45318-1611
(937) 573-6051
(937) 473-3184
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.0900412
OH
Other
Enumeration date
05/17/2016
Last updated
05/17/2016
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