Provider Demographics
NPI:1295428522
Name:BURT, DENISA IULIANA
Entity type:Individual
Prefix:
First Name:DENISA
Middle Name:IULIANA
Last Name:BURT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WOODLAND RD STE 119
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1710
Mailing Address - Country:US
Mailing Address - Phone:781-321-0645
Mailing Address - Fax:781-321-0679
Practice Address - Street 1:3 WOODLAND RD STE 119
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1710
Practice Address - Country:US
Practice Address - Phone:781-321-0645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist