Provider Demographics
NPI:1699818666
Name:BURKE, TERRY LEE (BA)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LEE
Last Name:BURKE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1023
Mailing Address - Country:US
Mailing Address - Phone:503-225-5786
Mailing Address - Fax:530-225-5245
Practice Address - Street 1:1506 MARKET ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1023
Practice Address - Country:US
Practice Address - Phone:530-225-5786
Practice Address - Fax:530-225-5245
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker