Provider Demographics
NPI:1760040919
Name:MIRREH, NASRA MOHAMED (MSW)
Entity Type:Individual
Prefix:
First Name:NASRA
Middle Name:MOHAMED
Last Name:MIRREH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4058 CREEK STATION LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-7003
Mailing Address - Country:US
Mailing Address - Phone:404-287-5406
Mailing Address - Fax:404-296-8743
Practice Address - Street 1:4058 CREEK STATION LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-7003
Practice Address - Country:US
Practice Address - Phone:404-287-5406
Practice Address - Fax:404-296-8743
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management