Individual
KELLY DAWN BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3514 STELLHORN RD, FORT WAYNE, IN 46815-4631
(859) 267-0705
Mailing address
6721 CLOVERCREST DR, FORT WAYNE, IN 46815-5403
(859) 494-1420
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/12/2010
Last updated
04/08/2025
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