Provider Demographics
NPI:1134352172
Name:BURNS, YVONNE INGRAM (MA)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:INGRAM
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611-0008
Mailing Address - Country:US
Mailing Address - Phone:662-838-3431
Mailing Address - Fax:
Practice Address - Street 1:4212 HIGHWAY 309 S
Practice Address - Street 2:
Practice Address - City:BYHALIA
Practice Address - State:MS
Practice Address - Zip Code:38611
Practice Address - Country:US
Practice Address - Phone:662-838-3431
Practice Address - Fax:662-838-3778
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2886235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist