MEDICARE: MS. MADISON ROSE 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
1	235Z00000X	Speech-Language Pathologist	120607	TX

General Provider Information

NPI Number	:	1427832120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MADISON ROSE BURKE M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	11201 BROOK GREEN LN
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-4122
Country	:	US
Telephone Number	:	214-235-5978
Fax Number	:

Provider Business Practice Location Address
First Line	:	8850 ELBE TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76118-7408
Country	:	US
Telephone Number	:	817-399-3434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	08/23/2024

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Directions to “ MS. MADISON ROSE BURKE M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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