Provider Demographics
NPI:1215546775
Name:ADLJOOI, AILIN (QBA, LBA-NC)
Entity type:Individual
Prefix:
First Name:AILIN
Middle Name:
Last Name:ADLJOOI
Suffix:
Gender:F
Credentials:QBA, LBA-NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5518 CLYDEBANK RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1164
Mailing Address - Country:US
Mailing Address - Phone:336-740-4511
Mailing Address - Fax:
Practice Address - Street 1:210 CHARLOIS BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1508
Practice Address - Country:US
Practice Address - Phone:336-740-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2335103K00000X
NCRBT-20-141415106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician