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NPI Code Detail

MEDICARE: ADRIKA RAHIM

MEDICARE:   ADRIKA  RAHIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1063021186
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIKA RAHIM
Provider Business Mailing Address
First Line : 10538 KATIE CREEK CT
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-2111
Country : US
Telephone Number : 919-454-3701
Fax Number :
Provider Business Practice Location Address
First Line : 3000 LATROBE DR STE B
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-5227
Country : US
Telephone Number : 704-780-4271
Fax Number : 888-261-6694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2020
Last Update Date : 07/24/2020

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Directions to “ ADRIKA RAHIM ” Practice Location

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