Provider Demographics
NPI:1093029225
Name:EASTON, AIMEE LASHAUN (BA)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LASHAUN
Last Name:EASTON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 11TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-3833
Mailing Address - Country:US
Mailing Address - Phone:701-220-7620
Mailing Address - Fax:
Practice Address - Street 1:1512 11TH AVE W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-3833
Practice Address - Country:US
Practice Address - Phone:701-220-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND54516Medicaid