Provider Demographics
NPI:1508229337
Name:KDBURNS ASSOCIATES, LLC
Entity Type:Organization
Organization Name:KDBURNS ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:DIETRICH-BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:443-380-2652
Mailing Address - Street 1:6349 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1008
Mailing Address - Country:US
Mailing Address - Phone:443-380-2652
Mailing Address - Fax:
Practice Address - Street 1:6349 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1008
Practice Address - Country:US
Practice Address - Phone:443-380-2652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty