Provider Demographics
NPI:1548597248
Name:BURNETT, DEBRA LYNN (MA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CAMPUS CREEK COMPLEX
Mailing Address - Street 2:KSU SPEECH & HEARING CENTER
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66506-7500
Mailing Address - Country:US
Mailing Address - Phone:785-532-6879
Mailing Address - Fax:785-532-6523
Practice Address - Street 1:139 CAMPUS CREEK COMPLEX
Practice Address - Street 2:KSU SPEECH & HEARING CENTER
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66506-7500
Practice Address - Country:US
Practice Address - Phone:785-532-6879
Practice Address - Fax:785-532-6523
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist