Provider Demographics
NPI:1477764512
Name:BURFORD, VICKI NIEMANTS
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:NIEMANTS
Last Name:BURFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:MARIE
Other - Last Name:NIEMANTSVERDRIET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, EDD
Mailing Address - Street 1:2740 GREGORY DR S
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0510
Mailing Address - Country:US
Mailing Address - Phone:406-656-6658
Mailing Address - Fax:
Practice Address - Street 1:902 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1637
Practice Address - Country:US
Practice Address - Phone:406-252-6082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical