Nawar Ismail

Individual provider Active NPI Behavior Analyst · Fargo, ND

NPI 1972169803 · NPPES record last updated Dec 5, 2023

Key facts

NPI
1972169803
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
L122 (ND)
Practice address
3120 25TH St S Ste 340Z
Fargo, ND 58103-6110
Phone
(701) 630-8795
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L122NDMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Technician 106S00000X
Behavior Analyst 103K00000X L122 ND Yes

Addresses

Primary practice location

3120 25TH St S Ste 340Z
Fargo, ND 58103-6110

Mailing address

3120 25TH St S Ste 340Z
Fargo, ND 58103-6110
Phone (701) 630-8795

Other practice location 1

647 13th Ave E
West Fargo, ND 58078-3328
Phone (701) 277-8844 ext. 70127

Other providers in Fargo, ND

All providers in Fargo, ND · Behavior Analyst in North Dakota

Sources for this page

Verify at the official NPI Registry.