Provider Demographics
NPI:1376852863
Name:BURDETTE, CARLA JANEEN (MASTER OF ARTS)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:JANEEN
Last Name:BURDETTE
Suffix:
Gender:F
Credentials:MASTER OF ARTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 MARSH AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-3042
Mailing Address - Country:US
Mailing Address - Phone:816-316-7940
Mailing Address - Fax:
Practice Address - Street 1:10900 MARSH AVE.
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134
Practice Address - Country:US
Practice Address - Phone:816-316-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist