Provider Demographics
NPI:1841958279
Name:BURKS - TOWNS, LA RYNDA DAWNYAE
Entity type:Individual
Prefix:MRS
First Name:LA RYNDA
Middle Name:DAWNYAE
Last Name:BURKS - TOWNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 E 126TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2138
Mailing Address - Country:US
Mailing Address - Phone:216-403-4983
Mailing Address - Fax:
Practice Address - Street 1:13110 SHAKER SQ STE 200C
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2381
Practice Address - Country:US
Practice Address - Phone:216-512-0321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator