Basic Information
| Provider Information | |||||||||
| NPI: | 1225198526 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURNEY | ||||||||
| FirstName: | LEE ANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4961 104TH WAY N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337083301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273976228 | ||||||||
| FaxNumber: | 7273190629 | ||||||||
| Practice Location | |||||||||
| Address1: | 3950 3RD ST N STE D | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337036123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278968086 | ||||||||
| FaxNumber: | 7278961017 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA 4622 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | SA4822 | 01 | FL | STATE LISENSE | OTHER |