Individual
MICHAEL BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LASAC
Contact information
Practice address
32 S MACDONALD, MESA, AZ 85210-1310
(480) 969-1471
(480) 264-0687
Mailing address
32 S MACDONALD, MESA, AZ 85210-1310
(480) 969-1471
(480) 264-0687
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15077
AZ
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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