Provider Demographics
NPI:1902956758
Name:BURNS, DANA CAROL (MA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:CAROL
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 ROCKINGHAM RD.
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2107
Mailing Address - Country:US
Mailing Address - Phone:603-425-2989
Mailing Address - Fax:603-425-2978
Practice Address - Street 1:63 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3402
Practice Address - Country:US
Practice Address - Phone:603-524-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH7706646Y0NH01OtherANTHEM