Provider Demographics
NPI:1083355408
Name:BURNS, CATIBRA E
Entity Type:Individual
Prefix:MRS
First Name:CATIBRA
Middle Name:E
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2146 HIGHWAY 15 S
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-6682
Mailing Address - Country:US
Mailing Address - Phone:843-597-3964
Mailing Address - Fax:
Practice Address - Street 1:2146 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:SC
Practice Address - Zip Code:29477-6682
Practice Address - Country:US
Practice Address - Phone:843-597-3964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst