Healthcare Provider Details

I. General information

NPI: 1245648906
Provider Name (Legal Business Name): MARIAM NAWABI MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SE 6TH ST APT 2504
MIAMI FL
33131-2566
US

IV. Provider business mailing address

55 SE 6TH ST UNIT 2504
MIAMI FL
33131-1022
US

V. Phone/Fax

Practice location:
  • Phone: 949-413-3756
  • Fax:
Mailing address:
  • Phone: 949-413-3756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-16533
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA0529
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: