Individual
MAIMOUNA DIALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2632 S 70TH ST, PHILADELPHIA, PA 19142-1703
(215) 480-0383
Mailing address
2632 S 70TH ST, PHILADELPHIA, PA 19142-1703
(215) 480-0383
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH006465
PA
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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