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NPI Code Detail

MEDICARE: JISSELLE AYALA

MEDICARE: JISSELLE AYALA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1326878356
Entity Type Code : Individual
Provider Name (Legal Business Name) : JISSELLE AYALA
Provider Business Mailing Address
First Line : 5325 WALL ST STE 1000
Second Line :
City : MADISON
State : WI
Zip : 53718-7983
Country : US
Telephone Number : 608-467-4834
Fax Number :
Provider Business Practice Location Address
First Line : 5325 WALL ST STE 1000
Second Line :
City : MADISON
State : WI
Zip : 53718-7983
Country : US
Telephone Number : 608-467-4834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2024
Last Update Date : 08/05/2024

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Directions to “ JISSELLE AYALA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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