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Individual

MRS. CATHY ANN BURTLESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC/SLP

Contact information

Practice address
99 GREELEY AVE, SAYVILLE, NY 11782-2300
(631) 244-6725
Mailing address
215 5TH ST, SAINT JAMES, NY 11780-2420
(631) 584-3273

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
58012720
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
58012720
NEW YORK STATE LICENSE
NY
Enumeration date
12/19/2011
Last updated
12/19/2011
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