Provider Demographics
NPI:1306375746
Name:BURL, ANIYA KESEAN
Entity Type:Individual
Prefix:
First Name:ANIYA
Middle Name:KESEAN
Last Name:BURL
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 1:2425 WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2331
Mailing Address - Country:US
Mailing Address - Phone:504-617-2525
Mailing Address - Fax:
Practice Address - Street 1:2425 WILLIAMSBURG DR
Practice Address - Street 2:
Practice Address - City:LAPLACE
Practice Address - State:LA
Practice Address - Zip Code:70068
Practice Address - Country:US
Practice Address - Phone:504-617-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health