Basic Information
| Provider Information | |||||||||
| NPI: | 1053935288 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURTKA | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1679 N CASS ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532024711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487192467 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1640 E SUMNER ST | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530272684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2626704000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2020 | ||||||||
| LastUpdateDate: | 12/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 4904-154 | WI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.