MEDICARE: MRS. SAMREENA RAHMAN 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	103K00000X	Behavior Analyst	12154681	CA

General Provider Information

NPI Number	:	1811583339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAMREENA RAHMAN BCBA

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	10777 WESTHEIMER RD STE 1100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-3462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	12/18/2020
Last Update Date	:	03/05/2026

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