Provider Demographics
NPI:1972241214
Name:BURKS, ASHLEY (MA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BURKS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 PINE ST
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2914
Mailing Address - Country:US
Mailing Address - Phone:337-356-5943
Mailing Address - Fax:
Practice Address - Street 1:8340 BARINGER RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817
Practice Address - Country:US
Practice Address - Phone:225-753-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist