Provider Demographics
NPI:1851135354
Name:MAHABUB, ASIA
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:MAHABUB
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 1:534 JESSAMINE DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-3925
Mailing Address - Country:US
Mailing Address - Phone:407-907-4574
Mailing Address - Fax:
Practice Address - Street 1:210 TALS ROCK WAY STE 3
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1919
Practice Address - Country:US
Practice Address - Phone:919-745-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst