Rebecca Burkart

Individual provider Active NPI Speech-Language Pathologist · Cody, WY

NPI 1386090199 · NPPES record last updated Mar 29, 2018

Key facts

NPI
1386090199
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP#P9050 (AR)
Practice address
808 North Street 2531 Cougar
Cody, WY 82414-2901
Phone
(307) 527-7060
Fax
(307) 587-2497
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP#P9050ARMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#P9050 AR Yes

Addresses

Primary practice location

808 North Street 2531 Cougar
Cody, WY 82414-2901

Mailing address

PO Box 2901
Cody, WY 82414-2901
Phone (307) 527-7060

Other practice location 1

314 S 17th St
Fort Smith, AR 72901-3836
Phone (479) 782-1444

Other providers in Cody, WY

All providers in Cody, WY · Speech-Language Pathologist in Wyoming

Sources for this page

Verify at the official NPI Registry.