Provider Demographics
NPI:1912564329
Name:BURKART, LORI A (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:A
Last Name:BURKART
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 1:31690 CAROLYN LN
Mailing Address - Street 2:
Mailing Address - City:GOLD BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97444-8586
Mailing Address - Country:US
Mailing Address - Phone:541-373-3456
Mailing Address - Fax:
Practice Address - Street 1:CURRY MEDICAL CTR
Practice Address - Street 2:500 5TH STREET
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415
Practice Address - Country:US
Practice Address - Phone:888-873-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR015068235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist