Provider Demographics
NPI:1932503182
Name:NAJM, NADIA MARIE GHASSAN
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:MARIE GHASSAN
Last Name:NAJM
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 1:310 CRAWFORD CT
Mailing Address - Street 2:APT 3
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-1132
Mailing Address - Country:US
Mailing Address - Phone:860-488-0520
Mailing Address - Fax:
Practice Address - Street 1:310 CRAWFORD CT
Practice Address - Street 2:APT 3
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1132
Practice Address - Country:US
Practice Address - Phone:860-488-0520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer