Individual
GWEN MARIE BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4623 TROUSDALE DR, NASHVILLE, TN 37204
(615) 301-8431
Mailing address
4623 TROUSDALE DR, NASHVILLE, TN 37204-4584
(615) 301-8431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5453
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5453
STATE LICENSE
TN
Enumeration date
02/09/2018
Last updated
06/05/2019
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