Provider Demographics
NPI:1245648906
Name:NAWABI, MARIAM (MA, BCBA)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:NAWABI
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 1:55 SE 6TH ST
Mailing Address - Street 2:UNIT 2504
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1022
Mailing Address - Country:US
Mailing Address - Phone:949-413-3756
Mailing Address - Fax:
Practice Address - Street 1:9024 MISTY LEAF
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:949-413-3756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-16533103K00000X
NVLBA0529103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst