Individual
MISS LAVONIA M BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1272 LONG HILL RD, STIRLING, NJ 07980-1010
(908) 504-2700
Mailing address
555 1ST ST APT 250, HARRISON, NJ 07029-3185
(336) 406-1010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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