| Katie Burdick, Llc | |
|
642 Hilliard St Ste 1302 Manchester CT 06042-2705 | |
| (860) 748-5441 | |
| (860) 812-2442 |
| Full Name | Katie Burdick, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 642 Hilliard St Ste 1302, Manchester, Connecticut |
| Authorized Official Name and Position | Katherine Burdick (OWNER) |
| Authorized Official Contact | 8607485441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Burdick, Llc 642 Hilliard St Ste 1302 Manchester CT 06042-2705 Ph: (860) 748-5441 | Katie Burdick, Llc 642 Hilliard St Ste 1302 Manchester CT 06042-2705 Ph: (860) 748-5441 |
| NPI Number | 1306389424 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 09/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306389424 | NPI | - | NPPES |
| 008069258 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1537 (Connecticut) | Primary |
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