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General NPI Number Information
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NPI Number | 1275165912
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Entity Type | Individual
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Provider Name | ANNA BURANT MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 08/29/2020
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Provider Practice Location Address
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Address Line | 9301 N 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53223-1074
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Country | US
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Telephone | 608-235-6890
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Fax |
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Provider Business Mailing Address
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Address Line | 4118 N MORRIS BLVD
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City | SHOREWOOD
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State | WI
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Zip | 53211-1839
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Country | US
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Telephone |
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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 | 14304192
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License Number State | WI
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