Individual
IMAN KHALIL MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
2101 GARNER RD, RALEIGH, NC 27610-0114
(919) 787-6131
(919) 571-2932
Mailing address
3125 POPLARWOOD CT STE 203, RALEIGH, NC 27604-6445
(919) 787-6131
(919) 571-2932
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-30180
NC
Other
Enumeration date
04/19/2023
Last updated
08/02/2024
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