Individual
SIERRA LARAE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
210 S 12TH ST, BISMARCK, ND 58504-5622
(701) 222-3175
(701) 222-3186
Mailing address
210 S 12TH ST, BISMARCK, ND 58504-5622
(701) 222-3175
(701) 222-3186
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1118
ND
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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