Provider Demographics
NPI:1760710800
Name:BURNOS, VICTORIA FRANCES (MSP, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:FRANCES
Last Name:BURNOS
Suffix:
Gender:F
Credentials:MSP, CCC/SLP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:FRANCES
Other - Last Name:AIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSP, CFY/SLP
Mailing Address - Street 1:25 SWEETLAND CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5466
Mailing Address - Country:US
Mailing Address - Phone:770-366-3246
Mailing Address - Fax:
Practice Address - Street 1:3400 ANDERSON RD STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7651
Practice Address - Country:US
Practice Address - Phone:864-295-9890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist