Individual
AISHA R SHABAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1536 CATHARINE ST, PHILADELPHIA, PA 19146-2270
(302) 229-9709
Mailing address
1536 CATHARINE ST, PHILADELPHIA, PA 19146-2270
(267) 428-7839
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW021123
PA
Other
Enumeration date
02/29/2020
Last updated
04/06/2020
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