Provider Demographics
NPI:1235266347
Name:PATTERSON, FAATIMAH M (SLP)
Entity Type:Individual
Prefix:
First Name:FAATIMAH
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 ALEXANDER DARIUS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4364
Mailing Address - Country:US
Mailing Address - Phone:803-413-3947
Mailing Address - Fax:
Practice Address - Street 1:217 ALEXANDER DARIUS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4364
Practice Address - Country:US
Practice Address - Phone:803-413-3947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL5278235Z00000X
NVSP-1787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist