MEDICARE: FAHIM ZAMAN BCBA

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	106S00000X	Behavior Technician		GA
2	103K00000X	Behavior Analyst	1-23-70210	GA

General Provider Information

NPI Number	:	1720634744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAHIM ZAMAN BCBA

Provider Business Mailing Address
First Line	:	1321 MURFREESBORO PIKE STE 702
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-2679
Country	:	US
Telephone Number	:	844-359-7629
Fax Number	:	615-577-5654

Provider Business Practice Location Address
First Line	:	13000 DEERFIELD PKWY STE 112
Second Line	:
City	:	MILTON
State	:	GA
Zip	:	30004-6118
Country	:	US
Telephone Number	:	404-410-7600
Fax Number	:

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

Provider Enumeration Date	:	08/15/2019
Last Update Date	:	01/18/2024

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