Individual
MISS JUDITH LEA BURNETT-HAISTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
100 WESTSIDE DR., CHILD & FAMILY SERVICES, DOTHAN, AL 36303
(334) 793-2237
(334) 712-6256
Mailing address
100 WESTSIDE DR., CHILD & FAMILY SERVICES, DOTHAN, AL 36303
(334) 793-2237
(334) 712-6256
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2963
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136080
—
AL
01
—
511-13046
BC BS - AL
AL
Enumeration date
10/07/2009
Last updated
01/02/2014
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