Provider Demographics
NPI:1962688002
Name:BURROWS, MILDRED ROSE (LICSW)
Entity Type:Individual
Prefix:
First Name:MILDRED
Middle Name:ROSE
Last Name:BURROWS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 ALLISON AVE
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-6958
Mailing Address - Country:US
Mailing Address - Phone:508-880-0202
Mailing Address - Fax:508-880-2425
Practice Address - Street 1:68 ALLISON AVE
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-6958
Practice Address - Country:US
Practice Address - Phone:508-880-0202
Practice Address - Fax:508-880-2425
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10312071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical