Provider Demographics
NPI:1730654328
Name:BURNEY, IAN
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:BURNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 E COPELAND RD STE NO310
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4910
Mailing Address - Country:US
Mailing Address - Phone:817-265-2344
Mailing Address - Fax:
Practice Address - Street 1:1112 E COPELAND RD STE NO310
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4910
Practice Address - Country:US
Practice Address - Phone:817-265-2344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health