Provider Demographics
NPI:1437351160
Name:BURCH, LINDA DORETHA
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:DORETHA
Last Name:BURCH
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 1:2052 COLERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-5029
Mailing Address - Country:US
Mailing Address - Phone:314-867-6352
Mailing Address - Fax:
Practice Address - Street 1:2052 COLERIDGE DR
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-5029
Practice Address - Country:US
Practice Address - Phone:314-867-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist