Individual
NANCY BRADBURY BURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH LMHC
Contact information
Practice address
4833 W 106TH ST, SUPER SHAPE FITNESS, ZIONSVILLE, IN 46077
(317) 873-3662
Mailing address
646 LAKEVIEW DR, ZIONSVILLE, IN 46077
(317) 873-3662
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH6741
FL
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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