| Doctor Name: | MISS JUDITH LEA BURNETT-HAISTEN |
| NPI Number: | 1114252251 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 2963 |
| Business Practice Address: | 100 Westside Dr. Child & Family Services Dothan, AL - 36303 |
| Business Phone Number: | 3347932237 |
| Business Fax Number: | 3347126256 |
| Mailing Address: | 100 Westside Dr., Child & Family Services DOTHAN |
| State: | AL |
| Postal Code: | 36303 |
| Phone Number: | 3347932237 |
| Fax Number: | 3347126256 |
| NPI Enumeration Date: | 10/07/2009 |
| NPI Last Update Date: | 01/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| 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 |