Brandi Elizabeth Burque, Ph.D.
Psychologist, Clinical in Champaign, IL. Individual provider (NPI-1).
NPI number1952534026
StatusActive
Last updated in NPPESApr 5, 2013
Details
- NPI
- 1952534026
- Entity type
- Individual (NPI-1)
- Name
- Brandi Elizabeth Burque
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 24, 2009
- Last updated
- Apr 5, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 1614 | AL | Yes |
Practice location
3915 Rockdale DrChampaign, IL 61822-2051
Phone 954-802-7419
Mailing address
3915 Rockdale DrChampaign, IL 61822-2051
Phone 954-802-7419
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