Provider Demographics
NPI:1326255910
Name:BURSON, KATHY C (EDD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:C
Last Name:BURSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ALISON AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6660
Mailing Address - Country:US
Mailing Address - Phone:717-790-9393
Mailing Address - Fax:717-790-0469
Practice Address - Street 1:400 ALISON AVE
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055
Practice Address - Country:US
Practice Address - Phone:717-790-9393
Practice Address - Fax:717-790-0469
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006537L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist