Healthcare Provider Details

I. General information

NPI: 1699390674
Provider Name (Legal Business Name): ANN MARIE FAHEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 E PLEASANT VALLEY RD STE 100
INDEPENDENCE OH
44131-5545
US

IV. Provider business mailing address

7100 E PLEASANT VALLEY RD
INDEPENDENCE OH
44131-5544
US

V. Phone/Fax

Practice location:
  • Phone: 216-202-4042
  • Fax:
Mailing address:
  • Phone: 330-419-8867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86494
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: