Individual
MATT JAMES BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4073 HIGHWAY 53, HOSCHTON, GA 30548-2305
(770) 882-5884
(706) 658-0116
Mailing address
4073 HIGHWAY 53, HOSCHTON, GA 30548-2305
(770) 882-5884
(706) 658-0116
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
005247
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003154238A
—
GA
Enumeration date
07/10/2015
Last updated
07/10/2015
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