Provider Demographics
NPI:1215210224
Name:BURNS, JENNFIER CHRISTINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JENNFIER
Middle Name:CHRISTINE
Last Name:BURNS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SPRINGER AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2740
Mailing Address - Country:US
Mailing Address - Phone:724-366-3247
Mailing Address - Fax:
Practice Address - Street 1:62 SPRINGER AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2740
Practice Address - Country:US
Practice Address - Phone:724-366-3247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1345235Z00000X
PASL009154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist