MEDICARE: MANAR ABOUL-NOUR MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6451023437	MI
2	101YP2500X	Professional Counselor	6401225948	MI
3	101Y00000X	Counselor	6451023437	MI
4	101Y00000X	Counselor	6401225948	MI
5	101YM0800X	Mental Health Counselor	6401225948	MI
6	101YM0800X	Mental Health Counselor	6451023437	MI

General Provider Information

NPI Number	:	1023691805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANAR ABOUL-NOUR MA

Provider Business Mailing Address
First Line	:	8290 PROMENADE CIR
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-2664
Country	:	US
Telephone Number	:	804-874-1672
Fax Number	:

Provider Business Practice Location Address
First Line	:	8290 PROMENADE CIR
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-2664
Country	:	US
Telephone Number	:	804-874-1672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	04/17/2026

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Directions to “ MANAR ABOUL-NOUR MA” Practice Location

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