Provider Demographics
NPI:1518437680
Name:MARTIN, AILAH Y'LAN (MPH)
Entity Type:Individual
Prefix:
First Name:AILAH
Middle Name:Y'LAN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35145 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT HERMON
Mailing Address - State:LA
Mailing Address - Zip Code:70450-6329
Mailing Address - Country:US
Mailing Address - Phone:985-335-3182
Mailing Address - Fax:
Practice Address - Street 1:915 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-1718
Practice Address - Country:US
Practice Address - Phone:985-322-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health