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Individual

LISA C BURDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
1031 MORGANTON BLVD SW, LENOIR, NC 28645-5677
(828) 757-6226
(828) 757-6289
Mailing address
2288 GEORGE HAYES RD, BOONE, NC 28607-8493
(828) 757-6226
(828) 757-6289

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3123
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19914
NC BCBS
NC
05
7419914
NC
Enumeration date
06/16/2005
Last updated
09/13/2016
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