Provider Demographics
NPI:1275509010
Name:BURNHAM, JENNIFER PARKER (MS,CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:PARKER
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:MS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 SAINT VINCENTS DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1606
Mailing Address - Country:US
Mailing Address - Phone:208-933-9236
Mailing Address - Fax:205-933-9213
Practice Address - Street 1:1948 AL HIGHWAY 157
Practice Address - Street 2:SUITE 410
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-1502
Practice Address - Country:US
Practice Address - Phone:256-737-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL09139038231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510I640011Medicare PIN