Provider Demographics
NPI:1275082240
Name:MAALI, SABRINE AMJAD
Entity Type:Individual
Prefix:
First Name:SABRINE
Middle Name:AMJAD
Last Name:MAALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 TEMPEST WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5320
Mailing Address - Country:US
Mailing Address - Phone:321-438-3041
Mailing Address - Fax:
Practice Address - Street 1:3427 TEMPEST WAY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5320
Practice Address - Country:US
Practice Address - Phone:321-438-3041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician