Provider Demographics
NPI:1134305212
Name:BURKS, HARRIET ANITA (MHPP)
Entity Type:Individual
Prefix:MRS
First Name:HARRIET
Middle Name:ANITA
Last Name:BURKS
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-7217
Mailing Address - Country:US
Mailing Address - Phone:870-837-1495
Mailing Address - Fax:
Practice Address - Street 1:1269 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-5313
Practice Address - Country:US
Practice Address - Phone:870-836-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARNONEOtherMENTAL HEALTH PARAPROFES