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Individual

JACQUIN BURNS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W D.L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103-5159
(575) 268-9504
Mailing address
122 COCHRAN AVE E BLDG 575, CANNON AFB, NM 88103-5159
(575) 268-9504
(575) 763-0041

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-09291
NM

Other

Enumeration date
10/31/2016
Last updated
07/24/2025
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