Provider Demographics
NPI:1023332004
Name:BURRIS, ALISON ANN (MS)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:ANN
Last Name:BURRIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2454
Mailing Address - Country:US
Mailing Address - Phone:612-455-8422
Mailing Address - Fax:612-455-8423
Practice Address - Street 1:12 E 66TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2454
Practice Address - Country:US
Practice Address - Phone:612-455-8422
Practice Address - Fax:612-455-8423
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5792237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter