Provider Demographics
NPI:1588901920
Name:BURNETT, MARY YVONNE (MHR)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:YVONNE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:YVONNE
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHR
Mailing Address - Street 1:2680 N HIGHWAY 88
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-0409
Mailing Address - Country:US
Mailing Address - Phone:918-341-7580
Mailing Address - Fax:918-341-7977
Practice Address - Street 1:2680 N HIGHWAY 88
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-0409
Practice Address - Country:US
Practice Address - Phone:918-341-7580
Practice Address - Fax:918-341-7977
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health