Individual
DR. KATHLEEN R. BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, RN, CS
Contact information
Practice address
4 MILITIA DR, SUITE 17, LEXINGTON, MA 02421-4737
(781) 861-9797
(781) 861-9797
Mailing address
4 MILITIA DR, SUITE 17, LEXINGTON, MA 02421-4737
(781) 861-9797
(781) 861-9797
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6858
MA
103TC2200X
Clinical Child & Adolescent Psychologist
6858
MA
163WP0808X
Psychiatric/Mental Health Registered Nurse
116459
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212553000
MBC
MA
01
—
W05424
BC & BS
MA
Enumeration date
01/08/2007
Last updated
12/01/2008
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