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Individual

MR. JAMES LATROY BURKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
927 SOUTHVIEW RD, LOUISVILLE, KY 40214
(502) 905-8335
Mailing address
927 SOUTHVIEW RD, LOUISVILLE, KY 40214-3413
(502) 905-8335

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0114
KY
101YP2500X
Professional Counselor
Primary
173071
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
173071
KENTUCKY BOARD OF COUNSELING
KY
Enumeration date
06/12/2007
Last updated
07/26/2018
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