Individual
MRS. MARCIE A BURNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78 ROCK CREEK DR, MOUNTAIN HOME, AR 72653-5851
(870) 425-1501
Mailing address
78 ROCK CREEK DR, MOUNTAIN HOME, AR 72653-5851
(870) 425-1501
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
09135167
MD
235Z00000X
Speech-Language Pathologist
Primary
SP#1589
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139055721
—
AR
Enumeration date
11/18/2008
Last updated
11/18/2008
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