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Individual

STACEY LAURA BURKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4985 LOWER ROSWELL RD, BLDG 200, MARIETTA, GA 30068-4337
(770) 598-0132
Mailing address
4985 LOWER ROSWELL RD, BLDG 200, MARIETTA, GA 30068-4337
(770) 598-0132

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005412
GA

Other

Enumeration date
09/21/2015
Last updated
09/21/2015
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