Provider Demographics
NPI:1447776281
Name:ALAM, FARIHA (BCBA)
Entity type:Individual
Prefix:
First Name:FARIHA
Middle Name:
Last Name:ALAM
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 RIDGE HAVEN DR APT 511
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-9097
Mailing Address - Country:US
Mailing Address - Phone:817-832-5745
Mailing Address - Fax:
Practice Address - Street 1:1616 RIDGE HAVEN DR APT 511
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-9097
Practice Address - Country:US
Practice Address - Phone:817-832-5745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-17-36773106S00000X
TX1-22-61015103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-22-61015Medicaid