Provider Demographics
NPI:1215213947
Name:BURROW, DIANNA (MHPP)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:BURROW
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 1:1487 W KEISER AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:OSCEOLA
Mailing Address - State:AR
Mailing Address - Zip Code:72370-2806
Mailing Address - Country:US
Mailing Address - Phone:870-563-4500
Mailing Address - Fax:
Practice Address - Street 1:1487 W KEISER AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:OSCEOLA
Practice Address - State:AR
Practice Address - Zip Code:72370-2806
Practice Address - Country:US
Practice Address - Phone:870-563-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator