Provider Demographics
NPI:1639271257
Name:BUROKAS, KATHLEEN (MS,CCC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:BUROKAS
Suffix:
Gender:F
Credentials:MS,CCC
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 518
Mailing Address - Street 2:
Mailing Address - City:BRANT ROCK
Mailing Address - State:MA
Mailing Address - Zip Code:02020
Mailing Address - Country:US
Mailing Address - Phone:781-771-2977
Mailing Address - Fax:
Practice Address - Street 1:10 IOWA ST
Practice Address - Street 2:
Practice Address - City:BRANT ROCK
Practice Address - State:MA
Practice Address - Zip Code:02020
Practice Address - Country:US
Practice Address - Phone:781-771-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist