Individual
EZZA MELINA AHMAD MUSTAFFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2045 W NORTH AVE STE 2B, CHICAGO, IL 60647-5413
(773) 249-2921
Mailing address
878 N PAULINA ST APT 2, CHICAGO, IL 60622-5093
(515) 817-3828
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178.014078
IL
101YP2500X
Professional Counselor
Primary
180.015151
IL
Other
Enumeration date
08/24/2019
Last updated
02/13/2024
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