Individual
ALICIA BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 SUMMITT DR, BRANDENBURG, KY 40108-1435
(804) 551-1032
Mailing address
51 SUMMITT DR, BRANDENBURG, KY 40108-1435
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-69435
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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