Healthcare Provider Details

I. General information

NPI: 1578497574
Provider Name (Legal Business Name): IBTISSAM SAMLAOUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IBTISSAM SAMLAOUI MS,BCBA,LBA

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9643A JEFFERSON HWY
NEW ORLEANS LA
70123-2509
US

IV. Provider business mailing address

9643A JEFFERSON HWY
NEW ORLEANS LA
70123-2509
US

V. Phone/Fax

Practice location:
  • Phone: 877-418-2978
  • Fax: 866-500-2186
Mailing address:
  • Phone: 504-417-5779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: