Provider Demographics
NPI:1558574327
Name:BURNETT, ASHLEY RACHELLE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RACHELLE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 S JONES BLVD
Mailing Address - Street 2:APT. 2173
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6149
Mailing Address - Country:US
Mailing Address - Phone:702-799-8600
Mailing Address - Fax:
Practice Address - Street 1:2832 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5205
Practice Address - Country:US
Practice Address - Phone:702-799-0235
Practice Address - Fax:702-799-2835
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist