Provider Demographics
NPI:1093737991
Name:ABOUL-HOSN, NAWAL SAJIH (PHD, LMHC, LMFT, CAP)
Entity Type:Individual
Prefix:MS
First Name:NAWAL
Middle Name:SAJIH
Last Name:ABOUL-HOSN
Suffix:
Gender:F
Credentials:PHD, LMHC, LMFT, CAP
Other - Prefix:MS
Other - First Name:NAWAL
Other - Middle Name:SAJIH
Other - Last Name:ABOUL-HOSN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:310 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825-3216
Mailing Address - Country:US
Mailing Address - Phone:321-525-1556
Mailing Address - Fax:
Practice Address - Street 1:310 E MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-3216
Practice Address - Country:US
Practice Address - Phone:321-525-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health