Provider Demographics
NPI:1497983985
Name:BERNAZZANI BURKE, RENEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:BERNAZZANI BURKE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-0473
Mailing Address - Country:US
Mailing Address - Phone:617-281-2002
Mailing Address - Fax:
Practice Address - Street 1:64 VILLAGE ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3244
Practice Address - Country:US
Practice Address - Phone:617-281-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist