Provider Demographics
NPI:1790186971
Name:BURCH, MARIE (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:BURCH
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODED EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-3026
Mailing Address - Country:US
Mailing Address - Phone:610-212-2980
Mailing Address - Fax:
Practice Address - Street 1:102 WOODED EAGLE CT
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-3026
Practice Address - Country:US
Practice Address - Phone:610-212-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist