Individual
GENISE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21620 N 19TH AVE, PHOENIX, AZ 85027-2716
(602) 690-9583
Mailing address
21620 N 19TH AVE STE A4, PHOENIX, AZ 85027-2716
(602) 690-9583
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA10676
AZ
Other
Enumeration date
07/05/2017
Last updated
07/05/2017
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