Provider Demographics
NPI:1568764231
Name:AOUDE, NASSIM SALIM (MS, BCBA)
Entity Type:Individual
Prefix:MR
First Name:NASSIM
Middle Name:SALIM
Last Name:AOUDE
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2211 ALA WAI BLVD APT 710
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2401
Mailing Address - Country:US
Mailing Address - Phone:323-774-7550
Mailing Address - Fax:808-926-8684
Practice Address - Street 1:17 BLUEGRASS LN
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-4263
Practice Address - Country:US
Practice Address - Phone:323-774-7550
Practice Address - Fax:808-926-8684
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-07-3452103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst