Individual
AALIYAH DEZUHA CONIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11606 SOUTHFORK AVE STE 300, BATON ROUGE, LA 70816-5238
(225) 292-5981
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R2422
LA
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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