Individual
SAM OMAR BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LSW
Contact information
Practice address
3910 CAUGHEY ROAD, SUITE 120, ERIE, PA 16506
(814) 541-5296
Mailing address
PO BOX 483, COCHRANTON, PA 16314-0483
(814) 882-2364
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW136084
PA
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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