Provider Demographics
NPI:1821405010
Name:FALL, ALIOUNE B
Entity Type:Individual
Prefix:
First Name:ALIOUNE
Middle Name:B
Last Name:FALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 REDWOOD ST APT 2906
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0837
Mailing Address - Country:US
Mailing Address - Phone:702-580-9605
Mailing Address - Fax:
Practice Address - Street 1:2301 REDWOOD ST APT 2906
Practice Address - Street 2:2301 REDWOOD STREET #2906
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0837
Practice Address - Country:US
Practice Address - Phone:702-580-9605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-19
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst