Provider Demographics
NPI:1316296742
Name:BURKE, JULIE CONNOR (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:CONNOR
Last Name:BURKE
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 1:3 GRIST MILL RD.
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1821
Mailing Address - Country:US
Mailing Address - Phone:203-414-3768
Mailing Address - Fax:
Practice Address - Street 1:3 GRIST MILL LN
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2485
Practice Address - Country:US
Practice Address - Phone:203-414-3768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003896235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist