=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386563708
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FAMO ALI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2026
-----------------------------------------------------
Last Update Date | 07/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5810 SHELBY OAKS DR STE B
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38134-7315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-550-3900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 157 RISING PVT LN
-----------------------------------------------------
City | GALLATIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37066-4798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------