| Doctor Name: | MISS TARA STARR BURGE |
| NPI Number: | 1043563505 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A.,CCC-SLP |
| License Number: | SP.8958 |
| Business Practice Address: | 303 N Hurstbourne Pkwy Suite 200 Louisville, KY - 402225185 |
| Business Phone Number: | 5024125847 |
| Business Fax Number: | 5022134697 |
| Mailing Address: | 303 N Hurstbourne Pkwy, Suite 200 LOUISVILLE |
| State: | KY |
| Postal Code: | 402225185 |
| Phone Number: | 5024125847 |
| Fax Number: | 5022134697 |
| NPI Enumeration Date: | 10/22/2012 |
| NPI Last Update Date: | 10/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP.8958 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| 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 |