Healthcare Provider Details

I. General information

NPI: 1497112189
Provider Name (Legal Business Name): JALYN AYO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11445 REIGER RD
BATON ROUGE LA
70809-4556
US

IV. Provider business mailing address

2110 N ALAMEDA DR
BATON ROUGE LA
70815-8809
US

V. Phone/Fax

Practice location:
  • Phone: 225-361-2933
  • Fax:
Mailing address:
  • Phone: 225-405-9136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10649
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: