Provider Demographics
NPI:1831300409
Name:BURKE, JANE H (MA,CCC-SLP/BCPA)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:H
Last Name:BURKE
Suffix:
Gender:F
Credentials:MA,CCC-SLP/BCPA
Other - Prefix:
Other - First Name:ALLYN
Other - Middle Name:HELSABECK
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP/BCPA
Mailing Address - Street 1:2673 ARBOR PLACE CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-1121
Mailing Address - Country:US
Mailing Address - Phone:336-682-3867
Mailing Address - Fax:
Practice Address - Street 1:2673 ARBOR PLACE CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-1121
Practice Address - Country:US
Practice Address - Phone:336-682-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411611Medicaid