| Shadia Ibrahim Ma Lmhc Llc | |
|
5 Washington St Ste 300 Valparaiso IN 46383-4769 | |
| (219) 730-7572 | |
| Not Available |
| Full Name | Shadia Ibrahim Ma Lmhc Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5 Washington St Ste 300, Valparaiso, Indiana |
| Authorized Official Name and Position | Shadia Ibrahim (OWNER) |
| Authorized Official Contact | 2197307572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadia Ibrahim Ma Lmhc Llc Po Box 2161 Portage IN 46368-5661 Ph: () - | Shadia Ibrahim Ma Lmhc Llc 5 Washington St Ste 300 Valparaiso IN 46383-4769 Ph: (219) 730-7572 |
| NPI Number | 1114674124 |
|---|---|
| Provider Enumeration Date | 03/09/2022 |
| Last Update Date | 03/09/2022 |
| Certification Date | 03/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114674124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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