Provider Demographics
NPI:1700051604
Name:BURROW, SHAUN (MMFT)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:BURROW
Suffix:
Gender:M
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 CORPORATE CIR
Mailing Address - Street 2:SUITE 129
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2292
Mailing Address - Country:US
Mailing Address - Phone:469-635-7540
Mailing Address - Fax:
Practice Address - Street 1:2904 CORPORATE CIR
Practice Address - Street 2:SUITE 129
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2292
Practice Address - Country:US
Practice Address - Phone:469-635-7540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201019106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist