Provider Demographics
NPI:1194051995
Name:BURNS, SANDRA BEATRICE
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:BEATRICE
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:BEATRICE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA ED
Mailing Address - Street 1:9045 ALEX CREEK AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3256
Mailing Address - Country:US
Mailing Address - Phone:702-325-7765
Mailing Address - Fax:
Practice Address - Street 1:9045 ALEX CREEK AVENUE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-3256
Practice Address - Country:US
Practice Address - Phone:702-325-7765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner