Provider Demographics
NPI:1609906940
Name:BURNETT, PRISCILLA GEDDES (MA)
Entity Type:Individual
Prefix:MISS
First Name:PRISCILLA
Middle Name:GEDDES
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 480914
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80248-0914
Mailing Address - Country:US
Mailing Address - Phone:303-455-0415
Mailing Address - Fax:303-296-4436
Practice Address - Street 1:2100 BROADWAY
Practice Address - Street 2:STOUT STREET BRIDGES
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2526
Practice Address - Country:US
Practice Address - Phone:303-296-4996
Practice Address - Fax:303-296-4436
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health