Individual
EBRAHIM MANSARAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
6025 N GREEN BAY AVE UPPR LEVEL, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Mailing address
6025 N GREEN BAY AVE UPPR LEVEL, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7626
WI
Other
Enumeration date
12/04/2023
Last updated
11/18/2024
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