MEDICARE: LEARN ME LLC

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1881231595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEARN ME LLC

Provider Business Mailing Address
First Line	:	11712 JEFFERSON AVE STE C476
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4406
Country	:	US
Telephone Number	:	757-354-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	11712 JEFFERSON AVE STE C476
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4406
Country	:	US
Telephone Number	:	757-354-2221
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FATOUMATA DIALLO
Credential	:	MED, BCBA, LBA
Telephone Number	:	757-478-4347

Provider Enumeration Date	:	12/02/2019
Last Update Date	:	12/02/2019

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Directions to “LEARN ME LLC ” Practice Location

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