Individual
MISS MARY ELIZABETH BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
292 S PINE ST STE B, SPARTANBURG, SC 29302-2673
(864) 591-3484
Mailing address
292 S PINE ST STE B, SPARTANBURG, SC 29302-2673
(864) 591-3484
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6073
SC
Other
Enumeration date
08/28/2017
Last updated
08/28/2017
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