Burch, Kathleen Suzanne

Burch, Kathleen Suzanne is an individual health care provider with primary practice located at 3615 Braselton Hwy Suite 103, Dacula GA 30019-5907. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Burch, Kathleen Suzanne can be contacted via phone (678) 377-9634.

Contact Information

Primary practice address
3615 Braselton Hwy Suite 103 Dacula GA 30019-5907
Phone: (678) 377-9634
Fax: (678) 377-9609
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005535 Georgia

Profile Details

NPI number 1568454114
LBN Legal business name Burch, Kathleen Suzanne
Credentials M.ED., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568454114 NPPES
Georgia MEDICAID 683352031A
Georgia MEDICAID 683352031B
Georgia Other 52071594-002
Georgia MEDICAID 10033355
Georgia Other 78119683
Georgia MEDICAID 306022

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