Tessa Ann Burgard, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · De Soto, MO

NPI 1053939389 · NPPES record last updated Sep 30, 2024

Key facts

NPI
1053939389
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2020025473 (MO)
Practice address
610 Vineland School Rd
De Soto, MO 63020-2561
Phone
(636) 586-1000
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2020025473MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
De Soto Public Schools Past
since Aug 28, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2020025473 MO Yes

Addresses

Primary practice location

610 Vineland School Rd
De Soto, MO 63020-2561

Mailing address

7891 Matterhorn Dr
Cedar Hill, MO 63016-2508

Other providers in De Soto, MO

All providers in De Soto, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.