Provider Demographics
NPI:1144571654
Name:MATTHEW-BURNETT, ANNETTE (CLINICIAN)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:MATTHEW-BURNETT
Suffix:
Gender:F
Credentials:CLINICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 COMMERCIAL ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1726
Mailing Address - Country:US
Mailing Address - Phone:508-752-4665
Mailing Address - Fax:508-752-0947
Practice Address - Street 1:250 COMMERCIAL ST
Practice Address - Street 2:SUITE 250
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1726
Practice Address - Country:US
Practice Address - Phone:508-752-4665
Practice Address - Fax:508-752-0947
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health