Individual
KENDRA LYNN BURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10530 SPOTSYLVANIA AVE STE 102, FREDERICKSBURG, VA 22408-2693
(540) 891-4485
Mailing address
3923 SAINT MICHAELS SQ, FREDERICKSBURG, VA 22408-7737
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007431
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202007431
LICENSE
VA
Enumeration date
07/07/2017
Last updated
06/16/2018
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