Individual
BETHANY BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 S DONALD ST, SEYMOUR, TX 76380-2812
(940) 256-1053
Mailing address
508 S DONALD ST, SEYMOUR, TX 76380-2812
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111375
TX
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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