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Individual
JADE BURBANK
Active
Individual
JADE BURBANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7651
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7651
—
LA
Enumeration date
08/26/2019
Last updated
08/26/2019
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