MEDICARE: PROF. YASMINE AWAIS ATR-BC, ATCS

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	101Y00000X	Counselor	PC0007426	PA
2	221700000X	Art Therapist	000355-1	NY

General Provider Information

NPI Number	:	1699190793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. YASMINE AWAIS ATR-BC, ATCS

Provider Business Mailing Address
First Line	:	1601 CHERRY ST
Second Line	:	MAIL STOP 7905
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-1320
Country	:	US
Telephone Number	:	267-359-5505
Fax Number	:	267-359-5579

Provider Business Practice Location Address
First Line	:	1601 CHERRY ST
Second Line	:	PARKWAY HEALTH & WELLNESS CENTER, FLOOR 2
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-1320
Country	:	US
Telephone Number	:	267-359-5505
Fax Number	:	267-359-5579

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

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	02/26/2014

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