MEDICARE: FATIMA AMJAD AHMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-22-58594	MD

General Provider Information

NPI Number	:	1467978536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA AMJAD AHMED

Provider Business Mailing Address
First Line	:	8189 ELKO DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7225
Country	:	US
Telephone Number	:	410-292-1317
Fax Number	:

Provider Business Practice Location Address
First Line	:	8189 ELKO DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7225
Country	:	US
Telephone Number	:	410-292-1317
Fax Number	:	410-292-1317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2017
Last Update Date	:	02/13/2024

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