Individual
ANGIE EBRAHEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAC
Contact information
Practice address
179 PALISADE AVE, JERSEY CITY, NJ 07306-1103
(201) 795-8126
Mailing address
176 PALISADE AVE, JERSEY CITY, NJ 07306-1196
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00817900
NJ
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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