Provider Demographics
NPI:1447792304
Name:AHMED, MARIA G
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:G
Last Name:AHMED
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 1:3565 W 22ND ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7626
Mailing Address - Country:US
Mailing Address - Phone:928-210-8685
Mailing Address - Fax:
Practice Address - Street 1:134 W 22ND ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6521
Practice Address - Country:US
Practice Address - Phone:928-446-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7393320253J00000X, 385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No253J00000XAgenciesFoster Care Agency