Provider Demographics
NPI:1295895662
Name:MCBURNEY, EDITH A (MA)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:A
Last Name:MCBURNEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:M
Other - Last Name:TRAUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2412 GREATSTONE POINT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:859-224-4081
Mailing Address - Fax:
Practice Address - Street 1:2412 GREATSTONE POINT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-224-4081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1212235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist