Individual
MISS JESSICA ERIN EBRAHIMZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3400 CIVIC CENTER BLVD FL 3, PHILADELPHIA, PA 19104-5127
(215) 349-5473
Mailing address
556 MARTIN ST, PHILADELPHIA, PA 19128-1619
(860) 508-3906
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC000156
PA
Other
Enumeration date
02/25/2014
Last updated
11/28/2017
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