Individual
JESSICA BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103224312
DRIVERS LICENSE
SC
05
—
421504
—
SC
Enumeration date
01/09/2014
Last updated
10/08/2018
Update your record
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