Dorothy Loretta Burgess, M.A.
Counselor, Professional in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1679697643
StatusActive
Last updated in NPPESMay 17, 2021
Details
- NPI
- 1679697643
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Dorothy Loretta Burgess
- Credential
- M.A.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 16, 2007
- Certification date
- May 17, 2021
- Last updated
- May 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 6401019357 | MI | Yes |
| 101YP2500X | Counselor, Professional | 6401010196 | MI |
Other names
- Lori Burgess (Professional Name)
Practice location
3744 28th St SeGrand Rapids, MI 49512-1802
Phone 616-466-7708 · Fax 616-466-7717
Mailing address
6549 Town Center Dr Ste AClarkston, MI 48346-4824
Phone 248-620-6400 · Fax 248-620-6405
Other practice locations
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