Provider Demographics
NPI:1922340868
Name:BURKS, ASHLEE LORRAINE
Entity Type:Individual
Prefix:MISS
First Name:ASHLEE
Middle Name:LORRAINE
Last Name:BURKS
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 1:7853 SCAMMONS BAY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7316
Mailing Address - Country:US
Mailing Address - Phone:614-302-9824
Mailing Address - Fax:
Practice Address - Street 1:3435 W CRAIG RD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5115
Practice Address - Country:US
Practice Address - Phone:702-657-6314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst