Provider Demographics
NPI:1245417443
Name:BURLIE-LAMB, JODI DAWN (TLMSW)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:DAWN
Last Name:BURLIE-LAMB
Suffix:
Gender:F
Credentials:TLMSW
Other - Prefix:MRS
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:BURLIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4728 CHOUTEAU ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-2300
Mailing Address - Country:US
Mailing Address - Phone:913-302-4264
Mailing Address - Fax:913-745-4044
Practice Address - Street 1:12351 W 96TH TER
Practice Address - Street 2:SUITE 300
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4409
Practice Address - Country:US
Practice Address - Phone:913-894-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7001104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker