Provider Demographics
NPI:1437676285
Name:BURG, JAMIE LYNN (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:BURG
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 AMANDA CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:PA
Mailing Address - Zip Code:17547-9216
Mailing Address - Country:US
Mailing Address - Phone:717-586-7476
Mailing Address - Fax:
Practice Address - Street 1:310 AMANDA CT
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:PA
Practice Address - Zip Code:17547-9216
Practice Address - Country:US
Practice Address - Phone:717-586-7476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty