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General NPI Number Information
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NPI Number | 1497234256
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Entity Type | Individual
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Provider Name | MEHWISH AQUEEL M.SC., LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2018
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Last Update Date | 08/12/2018
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Provider Practice Location Address
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Address Line | 9916 75TH ST
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City | KENOSHA
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State | WI
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Zip | 53142-7583
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Country | US
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Telephone | 262-484-5169
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Fax |
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Provider Business Mailing Address
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Address Line | 6615 103RD AVE
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City | KENOSHA
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State | WI
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Zip | 53142-7537
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Country | US
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Telephone | 262-221-0945
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.010488
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6594-125
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License Number State | WI
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