Individual
MR. IBRAHIM ADAM MOHAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
159 WIDENER ST, PHILADELPHIA, PA 19120-1950
(215) 305-2705
Mailing address
159 WIDENER ST, PHILADELPHIA, PA 19120-1950
(215) 305-2705
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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