Provider Demographics
NPI:1972201051
Name:PARAHAM, AISHA
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:
Last Name:PARAHAM
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 1:6837 S LAKEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1603
Mailing Address - Country:US
Mailing Address - Phone:404-227-1524
Mailing Address - Fax:
Practice Address - Street 1:1910 BRACKENDALE RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7749
Practice Address - Country:US
Practice Address - Phone:404-933-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator