Provider Demographics
NPI:1164527321
Name:BURNETTE, MARY FRANCES (MSW, LGSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:BURNETTE
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:FRAN
Other - Middle Name:
Other - Last Name:BURNETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LGSW
Mailing Address - Street 1:16033 DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35453-1057
Mailing Address - Country:US
Mailing Address - Phone:205-933-8101
Mailing Address - Fax:205-939-4576
Practice Address - Street 1:700 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1927
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:205-939-4576
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2050G1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical