Individual
PATRICIA LYNN BURGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2972 STATE ST, LAKE STATION, IN 46405-1864
(219) 945-2642
Mailing address
2906 HIGHWAY AVE, HIGHLAND, IN 46322-1631
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
IN
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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