Healthcare Provider Details

I. General information

NPI: 1053225532
Provider Name (Legal Business Name): JALAH SARIYA DUHON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11607 SOUTHFORK AVE
BATON ROUGE LA
70816-5220
US

IV. Provider business mailing address

16441 S HARRELLS FERRY RD
BATON ROUGE LA
70816-3599
US

V. Phone/Fax

Practice location:
  • Phone: 888-880-9270
  • Fax:
Mailing address:
  • Phone: 337-263-7861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number012972035
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: