Provider Demographics
NPI:1457452880
Name:BURLEIGH KLER, OLIVIA JO (SLP)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:JO
Last Name:BURLEIGH KLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 NEWBURY LN
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-6144
Mailing Address - Country:US
Mailing Address - Phone:337-662-6635
Mailing Address - Fax:
Practice Address - Street 1:145 NEWBURY LN
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6144
Practice Address - Country:US
Practice Address - Phone:337-662-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist