Doctor Name: | SIERRA LARAE BURGESS |
NPI Number: | 1013227727 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 1118 |
Business Practice Address: | 210 S 12th St Bismarck, ND - 585045622 |
Business Phone Number: | 7012223175 |
Business Fax Number: | 7012223186 |
Mailing Address: | 210 S 12th St, BISMARCK |
State: | ND |
Postal Code: | 585045622 |
Phone Number: | 7012223175 |
Fax Number: | 7012223186 |
NPI Enumeration Date: | 10/15/2010 |
NPI Last Update Date: | 10/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1118 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |