Provider Demographics
NPI:1720556939
Name:SIDDIQUI, FARHEEN (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:FARHEEN
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 E COPELAND RD STE 310
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4991
Mailing Address - Country:US
Mailing Address - Phone:817-265-2344
Mailing Address - Fax:
Practice Address - Street 1:1112 E COPELAND RD STE 310
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4991
Practice Address - Country:US
Practice Address - Phone:817-265-2344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-30484103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-18-30484OtherBEHAVIOR ANALYST CERTIFICATION BOARD, INC.