Individual
MICHELLE EVELYN LIECHTY BURBAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9730 HEALTHWAY DR, BERLIN, MD 21811-1154
(410) 629-0164
Mailing address
PO BOX 249, SNOW HILL, MD 21863-0249
(410) 632-1100
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
R111447
MD
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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