Individual
DR. JEANNETTE AYDELOTTE BURR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
120 ALLENS CREEK RD, ROCHESTER, NY 14618-3306
(585) 233-7420
Mailing address
120 ALLENS CREEK RD, ROCHESTER, NY 14618-3306
(585) 233-7420
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
015363
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015363
NYS LICENSE #
NY
01
—
P010115363
BCBS PROVIDER #
NY
Enumeration date
04/10/2006
Last updated
05/24/2013
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