Provider Demographics
NPI:1225607161
Name:FATIMA, HAJAB (MS, BCBA)
Entity type:Individual
Prefix:
First Name:HAJAB
Middle Name:
Last Name:FATIMA
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1294 ALMONT DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-3770
Mailing Address - Country:US
Mailing Address - Phone:404-839-7934
Mailing Address - Fax:
Practice Address - Street 1:1294 ALMONT DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-3770
Practice Address - Country:US
Practice Address - Phone:404-839-7934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-21-173012106S00000X
GA1-24-75107103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician