Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003322355 |
---|---|
Provider Name | Aisha Monalisa Yesufu |
First Address | Baton Rouge, LA 70809-2403 |
Second Address | Baton Rouge, LA 70809-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2017 |
Last Update Date | 22/12/2017 |