Provider Demographics
NPI:1609562156
Name:BURDETTE, CARA A (SLP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:A
Last Name:BURDETTE
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 1:9 PAYSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1309
Mailing Address - Country:US
Mailing Address - Phone:781-551-5812
Mailing Address - Fax:
Practice Address - Street 1:9 PAYSON RD STE 100
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1309
Practice Address - Country:US
Practice Address - Phone:781-551-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist