Provider Demographics
NPI:1205400975
Name:SALIM, JAMILA B (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:B
Last Name:SALIM
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-2822
Mailing Address - Country:US
Mailing Address - Phone:518-867-2021
Mailing Address - Fax:844-364-3239
Practice Address - Street 1:1 BRIDGE PLZ N STE 275
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7586
Practice Address - Country:US
Practice Address - Phone:201-849-4565
Practice Address - Fax:844-364-3239
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-48425103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932648086OtherORGANIZATION NPI