Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1255779229 |
---|---|
Provider Name | Sonya Alyce Burks |
First Address | North Las Vegas, NV 89030-5005 |
Second Address | Las Vegas, NV 89146-5605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 12/06/2013 |