Provider Demographics
NPI:1245792076
Name:KHEMRAJ, ASHLEY DOYLE (LAC, LMT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DOYLE
Last Name:KHEMRAJ
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 LONG ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3586
Mailing Address - Country:US
Mailing Address - Phone:913-349-7436
Mailing Address - Fax:
Practice Address - Street 1:8829 LONG ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3586
Practice Address - Country:US
Practice Address - Phone:913-349-7436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSMASST21-36031225700000X
KS23-00068171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist