Individual
AJA BURKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
17368 W 12 MILE RD STE 201, SOUTHFIELD, MI 48076
(313) 492-8452
(248) 856-3801
Mailing address
17368 W 12 MILE RD STE 201, SOUTHFIELD, MI 48076-6308
(313) 492-8452
(248) 856-3801
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
09/10/2010
Last updated
08/20/2018
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