Provider Demographics
NPI:1700528304
Name:ALNUAIMI, TABAREK (RBT, AID)
Entity Type:Individual
Prefix:
First Name:TABAREK
Middle Name:
Last Name:ALNUAIMI
Suffix:
Gender:F
Credentials:RBT, AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 BLUFFWAY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1729
Mailing Address - Country:US
Mailing Address - Phone:614-817-8350
Mailing Address - Fax:
Practice Address - Street 1:867 BLUFFWAY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1729
Practice Address - Country:US
Practice Address - Phone:614-817-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376K00000X
OHRBT-22-211238106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No376K00000XNursing Service Related ProvidersNurse's Aide