Provider Demographics
NPI:1568273167
Name:BURNS, PAULA ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ELIZABETH
Last Name:BURNS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GOLD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5013
Mailing Address - Country:US
Mailing Address - Phone:508-685-1030
Mailing Address - Fax:
Practice Address - Street 1:100 BORDEN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4803
Practice Address - Country:US
Practice Address - Phone:401-454-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist