Healthcare Provider Details

I. General information

NPI: 1356636518
Provider Name (Legal Business Name): AMARIY SHEMIYAH HALAHAWI ND, CCMA, CNA, NPA.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3695 CASCADE RD SW STE F #117
ATLANTA GA
30331-2146
US

IV. Provider business mailing address

3695 CASCADE RD SW STE F #117
ATLANTA GA
30331-2146
US

V. Phone/Fax

Practice location:
  • Phone: 678-909-4422
  • Fax:
Mailing address:
  • Phone: 678-909-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberLIC NO.08251986LPMT
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberNO. 1011-2793
License Number State
# 3
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberCCMA NO. 1022-2793
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCNA162739
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: