Emily Burzynski Clark, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3558-154 Issued in WI

Practice address

210 S. Park St
Friendship, WI 53934

Phone

(608) 339-3361

NPI assigned

Jul 19, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Emily Margaret Burzynski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1780972174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 130",
            "address_2": "201 S. PARK ST. VILLA PINES LIVING CENTER",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "53934",
            "telephone_number": "608-339-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S. PARK ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "53934",
            "telephone_number": "608-339-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EMILY",
        "middle_name": "BURZYNSKI",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3558-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BURZYNSKI",
            "middle_name": "MARGARET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin B. Beaver, PT
• William D Borkon, MD
• Brookridge Adult Family Home LLC
• Linda Charles
• Thomas L Charles, MSW, LCSW
• Complete Care at Villa Pines LLC
• County of Adams
• County of Adams
• Tamara Starr Daniels, M.D.
• Steven K Dankle, MD

• Speech-Language Pathologist in Friendship, WI
• Providers in Friendship, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.