Individual
SHADIA IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1441 E 84TH PL, MERRILLVILLE, IN 46410-6451
(219) 794-2000
(219) 794-2010
Mailing address
6741 PORTAGE AVE, PORTAGE, IN 46368-2432
(219) 730-7572
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002451A
IN
Other
Enumeration date
08/23/2013
Last updated
03/16/2022
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