Individual
MR. TOM WILLIAM BURNETT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4781 S GRAND ST, MONROE, LA 71202-6403
(318) 362-5430
(318) 362-5428
Mailing address
4781 S GRAND ST, MONROE, LA 71202-6403
(318) 362-5430
(318) 362-5428
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
791
LA
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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