Individual
AIGBOVBOISE AYO EHABAHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 W MARKET ST, 415, GREENSBORO, NC 27401
(786) 357-5426
Mailing address
850 W MARKET ST, 415, GREENSBORO, NC 27401
(786) 357-5426
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
XXXXXXXXXXXXXX
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003313404
—
FL
05
—
104576900
—
FL
Enumeration date
04/11/2018
Last updated
04/16/2024
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