Provider Demographics
NPI:1023480795
Name:BURNETT, PAULETTE
Entity type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 TALL OAKS DR
Mailing Address - Street 2:UNIT 1110
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1278
Mailing Address - Country:US
Mailing Address - Phone:847-376-2106
Mailing Address - Fax:
Practice Address - Street 1:1870 TALL OAKS DR
Practice Address - Street 2:UNIT 1110
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1278
Practice Address - Country:US
Practice Address - Phone:847-376-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health