Individual
BOCAR DIENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
131 HEATHERBRIDGE LN, BLACKLICK, OH 43004-9269
(404) 803-7080
Mailing address
131 HEATHERBRIDGE LN, BLACKLICK, OH 43004-9269
(404) 803-7080
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
UK685720
OH
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
UK685720
OH
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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