Provider Demographics
NPI:1932644572
Name:BURNS, HALINA OCHOTA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HALINA
Middle Name:OCHOTA
Last Name:BURNS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-0306
Mailing Address - Country:US
Mailing Address - Phone:410-829-1092
Mailing Address - Fax:
Practice Address - Street 1:8133 ELLIOTT RD
Practice Address - Street 2:SUITE 215
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2945
Practice Address - Country:US
Practice Address - Phone:410-829-1092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04741103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth