Provider Demographics
NPI:1316727464
Name:BURKS, KIRSTEN MIKAYLA
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MIKAYLA
Last Name:BURKS
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 1:1220 CATSKILL CIR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-4045
Mailing Address - Country:US
Mailing Address - Phone:256-604-9952
Mailing Address - Fax:
Practice Address - Street 1:1220 CATSKILL CIR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4045
Practice Address - Country:US
Practice Address - Phone:256-604-9952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker