Provider Demographics
NPI:1104595255
Name:BURLEIGH, ARDEN (SLP-CCC)
Entity type:Individual
Prefix:
First Name:ARDEN
Middle Name:
Last Name:BURLEIGH
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 TIMBERSIDE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3661
Mailing Address - Country:US
Mailing Address - Phone:713-501-5056
Mailing Address - Fax:
Practice Address - Street 1:3602 TIMBERSIDE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3661
Practice Address - Country:US
Practice Address - Phone:713-501-5056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-11
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist