Provider Demographics
NPI:1962525980
Name:BURNS, STEPHEN PAUL (OTRL)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:PAUL
Last Name:BURNS
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 PROFILE AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5924
Mailing Address - Country:US
Mailing Address - Phone:603-731-2299
Mailing Address - Fax:
Practice Address - Street 1:227 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2546
Practice Address - Country:US
Practice Address - Phone:603-223-3513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1351225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist