Provider Demographics
NPI:1255002002
Name:BURNS, MEREDITH (MS)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 N MCKISSOCK ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:MO
Mailing Address - Zip Code:64080-1445
Mailing Address - Country:US
Mailing Address - Phone:816-540-2220
Mailing Address - Fax:
Practice Address - Street 1:327 N MCKISSOCK ST
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:MO
Practice Address - Zip Code:64080-1445
Practice Address - Country:US
Practice Address - Phone:816-540-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021019477235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist