Most Relevant Information
Provider Data
| NPI Number: | 1003377904 |
| Provider Name: | JACQUELINE BURKETT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/26/2019 |
| Last Updated: | 03/26/2019 |
Provider Practice Location
2733 QUARRY HEIGHTS WAY
BALTIMORE
MD
212091080
Practice Location Phone/Fax
| Phone: | 4433861882 |
| Fax: | 8153018671 |
Provider Mailing Location
2733 QUARRY HEIGHTS WAY
BALTIMORE
MD
212091080
Provider Mailing Phone/Fax
| Phone: | 4433861882 |
| Fax: | 8153018671 |