Provider Demographics
NPI:1225198526
Name:BURNEY, LEE ANNE
Entity Type:Individual
Prefix:MRS
First Name:LEE ANNE
Middle Name:
Last Name:BURNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4961 104TH WAY N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-3301
Mailing Address - Country:US
Mailing Address - Phone:727-397-6228
Mailing Address - Fax:727-319-0629
Practice Address - Street 1:3950 3RD ST N STE D
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-6123
Practice Address - Country:US
Practice Address - Phone:727-896-8086
Practice Address - Fax:727-896-1017
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 4622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA4822OtherSTATE LISENSE