Healthcare Provider Details

I. General information

NPI: 1861335945
Provider Name (Legal Business Name): NOUR OSAMA IBRAHIM MOHAMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 ALBEMARLE RD
ASHEBORO NC
27203-6259
US

IV. Provider business mailing address

1170 BUNTING RD
ASHEBORO NC
27205-5900
US

V. Phone/Fax

Practice location:
  • Phone: 336-953-7049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: