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Individual

JEREMY BURKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSW, CDCA, LLBSW

Contact information

Practice address
24600 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-2471
(248) 871-1523
Mailing address
24600 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-2471
(248) 871-1523

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802090717
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2389
MI
Enumeration date
02/21/2020
Last updated
02/21/2020
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