Individual
PATRICIA POLK BURKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1201 5TH AVE N, ST PETERSBURG, FL 33705-1400
(727) 821-0017
(727) 822-7473
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY4694
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254016941
—
FL
Enumeration date
11/04/2005
Last updated
06/30/2023
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