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MS. JENIFER BURKETT MA MFT
>> Marriage & Family Therapist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1609887892
Individual Registrant:MS. JENIFER BURKETT MA MFT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
38550 S HIGHWAY 1 GUALALA, CA 95445-8592 US
Tel: 707-328-3544 Fax: --
Tel: 707-328-3544 Fax: --
Contact information for business:
P.O. BOX 6443 SANTA ROSA, CA 95403-4157 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1609887892
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist | CA | MFT30315 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
