Healthcare Provider Details

I. General information

NPI: 1659920239
Provider Name (Legal Business Name): SANJIDA NAHIYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 OLYMPIA DR
RALEIGH NC
27603-3712
US

IV. Provider business mailing address

3421 OLYMPIA DR STE 1000
RALEIGH NC
27603-3712
US

V. Phone/Fax

Practice location:
  • Phone: 919-391-9087
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: