| Doctor Name: | STACEY A BURTON |
| NPI Number: | 1467662965 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 118464 |
| Business Practice Address: | Republic R-iii 518 N Hampton Ave Republic, MO - 657381323 |
| Business Phone Number: | 4177323609 |
| Business Fax Number: | 4177323605 |
| Mailing Address: | 518 N Hampton Ave, REPUBLIC |
| State: | MO |
| Postal Code: | 657381323 |
| Phone Number: | 4177323609 |
| Fax Number: | 4177323605 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 02/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 118464 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| 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 |