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NPI Code Detail

MEDICARE: DARA K BURKE M.S.CCC-SLP

MEDICARE: DARA K BURKE M.S.CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist1002WV

General Provider Information

NPI Number : 1164639613
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARA K BURKE M.S.CCC-SLP
Provider Business Mailing Address
First Line : 108 SQUAW TER
Second Line :
City : MARTINSBURG
State : WV
Zip : 25403-1294
Country : US
Telephone Number : 304-283-4499
Fax Number :
Provider Business Practice Location Address
First Line : 208 OLD MILL RD
Second Line :
City : MARTINSBURG
State : WV
Zip : 25401-9219
Country : US
Telephone Number : 304-671-9604
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 11/09/2022

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Directions to “ DARA K BURKE M.S.CCC-SLP” Practice Location

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