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Individual

JENNIFER RENEE BURLESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1116 S WALTON BLVD STE 114, BENTONVILLE, AR 72712-6126
(479) 309-1973
Mailing address
5215 S BROOKMERE ST, ROGERS, AR 72758-5097
(917) 405-5514

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
076703
NY
1041C0700X
Clinical Social Worker
078868
NY
1041C0700X
Clinical Social Worker
Primary
11575-C
AR
1041C0700X
Clinical Social Worker
44SC05697100
NJ

Other

Enumeration date
04/01/2011
Last updated
05/04/2022
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