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General NPI Number Information
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NPI Number | 1134533722
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Entity Type | Individual
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Provider Name | STEFANIE ROSE BURNS M.A.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 2340 IRVING ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-1641
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Country | US
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Telephone | 201-788-4677
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 8TH AVE APT 2L
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City | BROOKLYN
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State | NY
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Zip | 11215-5677
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Country | US
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Telephone | 201-788-4677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22695
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 027828
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License Number State | NY
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