Individual
LYDIA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1930 MARLTON PIKE E, R91, CHERRY HILL, NJ 08003-2150
(856) 751-0505
Mailing address
1930 MARLTON PIKE E, R91, CHERRY HILL, NJ 08003-2150
(856) 751-0505
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00404200
NJ
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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