Individual
MIRANDA BURBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
200 S RITCHIE AVE, RAVENSWOOD, WV 26164-1721
(304) 273-9385
Mailing address
425 TUCKERS RUN, SPENCER, WV 25276-8213
(304) 927-4056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0780
WV
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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