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DAVID ALLEN BURRIS

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1437633088

Individual Registrant:
 DAVID ALLEN BURRIS 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1875 FANT DR  FORT OGLETHORPE, GA 30742-3307 US
Tel: 706-861-3387  Fax: 706-639-2054

Contact information for business:
84 SOUTHSHORE DR  FORT OGLETHORPE, GA 30742-4230 US
Tel: 706-506-7792  Fax: 706-944-4191

Registration Information:
NPI: 1437633088
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
GA1779

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00604513-GAGA05




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