Provider Demographics
NPI:1316384902
Name:BURLEY, LAKIM
Entity Type:Individual
Prefix:
First Name:LAKIM
Middle Name:
Last Name:BURLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7757 S VICTOR AVE
Mailing Address - Street 2:APT B
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7729
Mailing Address - Country:US
Mailing Address - Phone:918-850-7761
Mailing Address - Fax:
Practice Address - Street 1:7757 S VICTOR AVE
Practice Address - Street 2:APT B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7729
Practice Address - Country:US
Practice Address - Phone:918-850-7761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor