Healthcare Provider Details

I. General information

NPI: 1104752237
Provider Name (Legal Business Name): MARIAH MAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SAINT CHARLES AVE STE 2500
NEW ORLEANS LA
70170-2500
US

IV. Provider business mailing address

19268 DR JOHN LAMBERT DR APT 424
HAMMOND LA
70403-0964
US

V. Phone/Fax

Practice location:
  • Phone: 877-418-2978
  • Fax:
Mailing address:
  • Phone: 504-913-9821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: