Provider Demographics
NPI:1053920413
Name:BURGESS, MARGARET (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BURGESS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4767 S FULTONDALE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5835
Mailing Address - Country:US
Mailing Address - Phone:315-879-1499
Mailing Address - Fax:
Practice Address - Street 1:18900 E MAINSTREET
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3493
Practice Address - Country:US
Practice Address - Phone:720-728-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0002833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist