Provider Demographics
NPI:1326537051
Name:MUHAMMAD, FATIMAH N
Entity Type:Individual
Prefix:
First Name:FATIMAH
Middle Name:N
Last Name:MUHAMMAD
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 1:2067 LAKE PARK DR SE APT G
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7628
Mailing Address - Country:US
Mailing Address - Phone:678-235-4156
Mailing Address - Fax:
Practice Address - Street 1:2067 LAKE PARK DR SE APT G
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7628
Practice Address - Country:US
Practice Address - Phone:678-235-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty