Provider Demographics
NPI:1568093284
Name:ABDULRASOOL, SARAH ZAID (PROFESSIONAL COUNSEL)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ZAID
Last Name:ABDULRASOOL
Suffix:
Gender:F
Credentials:PROFESSIONAL COUNSEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 N GREEN BAY AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3811
Mailing Address - Country:US
Mailing Address - Phone:414-247-0801
Mailing Address - Fax:141-247-0816
Practice Address - Street 1:6025 N GREEN BAY AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3811
Practice Address - Country:US
Practice Address - Phone:414-247-0801
Practice Address - Fax:141-247-0816
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4555101YP2500X
WI10163101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI10163OtherLICENSE