Healthcare Provider Details

I. General information

NPI: 1154963858
Provider Name (Legal Business Name): FADIA MARAM SALMAN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6765 S EASTERN AVE STE 3
LAS VEGAS NV
89119-3945
US

IV. Provider business mailing address

3156 DEL TERRA AVE
HENDERSON NV
89044-0491
US

V. Phone/Fax

Practice location:
  • Phone: 702-582-7348
  • Fax:
Mailing address:
  • Phone: 702-561-5612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-102186
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-70479
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: