Provider Demographics
NPI:1225739030
Name:BURKHARD, ABBY
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:BURKHARD
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 1:21343 NORMAN SHORES DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6695
Mailing Address - Country:US
Mailing Address - Phone:704-575-9063
Mailing Address - Fax:
Practice Address - Street 1:13825 HUNTON LN # 6190
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6190
Practice Address - Country:US
Practice Address - Phone:704-897-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30000982235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist