Burks, Myna Laquisha
Burks, Myna Laquisha is an individual health care provider with primary practice located at 1129 Highway 35 S Ste 2 , Forest MS 39074-8829. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Burks, Myna Laquisha can be contacted via phone (601) 469-1001.Contact Information
Primary practice address
1129 Highway 35 S Ste 2
Forest MS 39074-8829
Phone: (601) 469-1001
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SP4186 | California |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | S3430 | Mississippi |
Profile Details
| NPI number | 1598968802 |
|---|---|
| LBN Legal business name | Burks, Myna Laquisha |
| Credentials | M.S. SLP-CCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2007 |
| Last updated | Oct 26th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598968802 | NPPES |
| Mississippi | Other | S3430 | MS STATE LICENSE |
| Mississippi | MEDICAID | 05722005 | MS STATE LICENSE |
| Mississippi | Other | SP4186 | MS STATE LICENSE |
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