Individual
STACEY A BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
REPUBLIC R-III, 518 N HAMPTON AVE, REPUBLIC, MO 65738-1323
(417) 732-3609
(417) 732-3605
Mailing address
518 N HAMPTON AVE, REPUBLIC, MO 65738-1323
(417) 732-3609
(417) 732-3605
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
118464
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465697613
—
MO
Enumeration date
05/23/2007
Last updated
02/23/2009
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