Individual
MARYAN MOHAMED SALIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1122 GAMMON LN, MADISON, WI 53719-2211
(504) 270-2294
Mailing address
1122 GAMMON LN, MADISON, WI 53719-2211
(504) 270-2294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0018483
WI
3747A0650X
Attendant Care Provider
Primary
0018483
WI
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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