Individual
LIZA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1012 BROAD ST, BLOOMFIELD, NJ 07003-2807
(973) 338-1244
(973) 338-1544
Mailing address
1012 BROAD ST, BLOOMFIELD, NJ 07003-2807
(973) 338-1244
(973) 338-1544
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00714600
PROFESSIONAL LICENSE
NJ
Enumeration date
12/07/2020
Last updated
12/07/2020
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