Provider Demographics
NPI:1316777501
Name:ALMOHANNA, FATIMAH L
Entity type:Individual
Prefix:
First Name:FATIMAH
Middle Name:L
Last Name:ALMOHANNA
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 1:315 N BEHREND AVE APT C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5806
Mailing Address - Country:US
Mailing Address - Phone:443-333-6117
Mailing Address - Fax:
Practice Address - Street 1:1300 E 20TH ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-9022
Practice Address - Country:US
Practice Address - Phone:505-402-6886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst