Provider Demographics
NPI:1629841804
Name:BURGER, FAYE MARIE (MA)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:MARIE
Last Name:BURGER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 BERTLING ST APT 112
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-3071
Mailing Address - Country:US
Mailing Address - Phone:618-367-3115
Mailing Address - Fax:
Practice Address - Street 1:1112 BERTLING ST APT 112
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-3071
Practice Address - Country:US
Practice Address - Phone:618-367-3115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health