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Individual

BURTON ALEXANDER SHADOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3540 MANDERLY PL, FORT WORTH, TX 76109-4520
(817) 739-8174
Mailing address
3540 MANDERLY PL, FORT WORTH, TX 76109-4520
(817) 739-8174

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
35209
TX

Other

Enumeration date
08/12/2025
Last updated
08/12/2025
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