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NPI 1346137338

NPI 1346137338 : ABBRA AHMAD M.ED, LAC : BUCKEYE, AZ

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General NPI Number Information
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    NPI Number           |    1346137338
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    Entity Type          |    Individual 
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    Provider Name        |    ABBRA AHMAD M.ED, LAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/21/2025
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    Last Update Date     |    07/07/2025
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Provider Practice Location Address
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    Address Line         |    726 E MONROE AVE 
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    City                 |    BUCKEYE
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    State                |    AZ
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    Zip                  |    85326-3071
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    Country              |    US
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    Telephone            |    480-938-0546
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    20728 W HAMILTON ST 
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    City                 |    BUCKEYE
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    State                |    AZ
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    Zip                  |    85396-7774
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    Country              |    US
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    Telephone            |    480-938-0546
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    LAC-08285T
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    License Number State |    AZ
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