Provider Demographics
NPI:1346083474
Name:LAWRENCE, ASHLEY SHANNON (HEALTH COACH)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHANNON
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-3941
Mailing Address - Country:US
Mailing Address - Phone:316-308-1133
Mailing Address - Fax:
Practice Address - Street 1:1217 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-3941
Practice Address - Country:US
Practice Address - Phone:316-308-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7932171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach