Individual
ASHLEIGH MIMMS DYESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7932 SUMMA AVE STE B2, BATON ROUGE, LA 70809-3736
(225) 349-7163
Mailing address
14086 AIRLINE HWY APT 1723, GONZALES, LA 70737-0616
(404) 934-9528
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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