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NPI 1518654219

NPI 1518654219 : TENA NICOLE BURNS M.A.ED., CCC-SLP : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1518654219
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    Entity Type          |    Individual 
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    Provider Name        |    TENA NICOLE BURNS M.A.ED., CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/21/2023
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    Last Update Date     |    01/08/2024
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Provider Practice Location Address
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    Address Line         |    2701 CHESTNUT STATION CT 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40299-6395
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    Country              |    US
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    Telephone            |    800-335-1060
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    51 HEARTH STONE DR 
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    City                 |    MANCHESTER
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    State                |    KY
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    Zip                  |    40962-6085
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    Country              |    US
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    Telephone            |    606-594-4777
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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       |    14413689
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    License Number State |    KY
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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       |    281709
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    License Number State |    KY
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