Individual
MICHAELINE BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2525
(701) 234-2431
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
22925
MN
1041C0700X
Clinical Social Worker
Primary
4996
ND
Other
Enumeration date
12/30/2013
Last updated
07/29/2014
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