Provider Demographics
NPI:1619656493
Name:LASLEY, KIRA MARIE (BS)
Entity Type:Individual
Prefix:MRS
First Name:KIRA
Middle Name:MARIE
Last Name:LASLEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:KIRA
Other - Middle Name:MARIE
Other - Last Name:CRIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:135 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1219
Mailing Address - Country:US
Mailing Address - Phone:304-525-5691
Mailing Address - Fax:304-525-5693
Practice Address - Street 1:135 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1219
Practice Address - Country:US
Practice Address - Phone:304-525-5691
Practice Address - Fax:304-525-5693
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)