Provider Demographics
NPI:1730726092
Name:FAHIE, MALIKA
Entity type:Individual
Prefix:
First Name:MALIKA
Middle Name:
Last Name:FAHIE
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 1:160 SINCLAIR ST APT 151
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-2043
Mailing Address - Country:US
Mailing Address - Phone:340-227-3201
Mailing Address - Fax:
Practice Address - Street 1:160 SINCLAIR ST APT 151
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2043
Practice Address - Country:US
Practice Address - Phone:340-227-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner