Provider Demographics
NPI:1396127270
Name:BURKE, CIARA (MED, BCBA)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:997 ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-3311
Mailing Address - Country:US
Mailing Address - Phone:904-755-4947
Mailing Address - Fax:
Practice Address - Street 1:3520 DELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-5426
Practice Address - Country:US
Practice Address - Phone:904-755-4947
Practice Address - Fax:904-647-2625
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst