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NPI Code Detail

MEDICARE: MAMOUNA DIALLO

MEDICARE:   MAMOUNA  DIALLO
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 : 1477374148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAMOUNA DIALLO
Provider Business Mailing Address
First Line : 198 YORKWOOD LN
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-6120
Country : US
Telephone Number : 513-859-0822
Fax Number :
Provider Business Practice Location Address
First Line : 7243 EASTLAWN DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3515
Country : US
Telephone Number : 513-740-1001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2024
Last Update Date : 10/24/2024

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Directions to “ MAMOUNA DIALLO ” Practice Location

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