Individual
MRS. REBECCA ANN BURDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PROFESSIONAL COU
Contact information
Practice address
920 60TH STREET, RENOSHA, WI 53140
(262) 654-5333
(262) 654-7818
Mailing address
920 60TH STREET, RENOSHA, WI 53140
(262) 654-5333
(262) 654-7818
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
240-226
WI
103TH0004X
Health Psychologist
240-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42133400
—
WI
Enumeration date
08/13/2007
Last updated
04/28/2009
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