Provider Demographics
NPI:1801007653
Name:BURKE, CATHERINE A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 AMPHITHEATER RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4302
Mailing Address - Country:US
Mailing Address - Phone:205-664-9313
Mailing Address - Fax:205-664-1934
Practice Address - Street 1:203 AMPHITHEATER RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4302
Practice Address - Country:US
Practice Address - Phone:205-664-9313
Practice Address - Fax:205-664-1934
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL625235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051042513OtherBLUECROSS BLUESHIELD AL
AL890001700Medicaid