Individual
CAMMI BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
107 W 2ND ST, EMMETT, ID 83617-2909
(208) 869-9409
Mailing address
107 W 2ND ST, EMMETT, ID 83617-2909
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3029
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14090048
CERTIFICATE OF CLINICAL COMPENTANCY
—
01
—
SLP-3029
SLP STATE LICENSE
ID
Enumeration date
10/11/2022
Last updated
10/11/2022
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