Provider Demographics
NPI:1174004691
Name:SHAREEF, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:SHAREEF
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 1:32285 GLEN CV APT 8
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3662
Mailing Address - Country:US
Mailing Address - Phone:313-674-6492
Mailing Address - Fax:
Practice Address - Street 1:32285 GLEN CV APT 8
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3662
Practice Address - Country:US
Practice Address - Phone:313-674-6492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY292401103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst