Individual
FIRDAUS BOUFATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9721 165TH ST STE 21, ORLAND PARK, IL 60467-4511
(708) 671-8946
Mailing address
9321 S 69TH CT, OAK LAWN, IL 60453-2040
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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