Provider Demographics
NPI:1548035355
Name:BABAYEVA, LALA (MED)
Entity type:Individual
Prefix:
First Name:LALA
Middle Name:
Last Name:BABAYEVA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 COURTNEY RIDGE LN APT 523
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-4538
Mailing Address - Country:US
Mailing Address - Phone:172-463-0460
Mailing Address - Fax:
Practice Address - Street 1:4925 COURTNEY RIDGE LN APT 523
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-4538
Practice Address - Country:US
Practice Address - Phone:172-463-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst