Provider Demographics
NPI:1811768237
Name:LIGGANS, AYYUB ILYAS
Entity type:Individual
Prefix:
First Name:AYYUB
Middle Name:ILYAS
Last Name:LIGGANS
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 1:6561 QUIET HOURS APT 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5142
Mailing Address - Country:US
Mailing Address - Phone:301-455-1850
Mailing Address - Fax:
Practice Address - Street 1:11720 BELTSVILLE DR STE 500A15
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3166
Practice Address - Country:US
Practice Address - Phone:240-360-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician