Joshuaa Dominic Allison-Burbank, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Shiprock, NM
NPI 1114302148 · NPPES record last updated Feb 21, 2020
Key facts
- NPI
- 1114302148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4024 (KS)
- Practice address
- US Hwy 491 North
Shiprock, NM 87420 - Phone
- (505) 368-6001
- NPI assigned
- Jul 20, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4024 | KS | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4024 | KS | Yes |
Addresses
Primary practice location
US Hwy 491 North
Shiprock, NM 87420
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001
Other providers in Shiprock, NM
- Madison Lee Adams
- Steve J. Adams
- Jerren Michael Alcalde
- Lisa H Allee
- Johnny Allen
- Kristi Rose Anderson
- Iris Anthony
- Hope Arhelger
- Kerrianne Ashley
- Danielle R Atencio-Archibeque
All providers in Shiprock, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.