Provider Demographics
NPI:1205652708
Name:BURROWS, PORSHIA
Entity type:Individual
Prefix:
First Name:PORSHIA
Middle Name:
Last Name:BURROWS
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 1:3539 DOUGLAS DR N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2415
Mailing Address - Country:US
Mailing Address - Phone:612-642-1355
Mailing Address - Fax:
Practice Address - Street 1:3534 DOUGLAS DR N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-2416
Practice Address - Country:US
Practice Address - Phone:612-642-1355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health