Individual
FIDA ABDELRASOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
505 W UNIVERSITY AVE STE 211, CHAMPAIGN, IL 61820-3915
(224) 338-7754
Mailing address
505 W UNIVERSITY AVE STE 211, CHAMPAIGN, IL 61820-3915
(224) 338-7754
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
150.103891
IL
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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