Provider Demographics
NPI:1962012229
Name:EL GAZZAR, SHEREEN
Entity Type:Individual
Prefix:
First Name:SHEREEN
Middle Name:
Last Name:EL GAZZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SYRIA ST. MOHANDESSIN, GIZA, APT. 82
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GIZA
Mailing Address - Zip Code:20202
Mailing Address - Country:EG
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 SYRIA ST. MOHANDESSIN, GIZA, APT. 82
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GIZA
Practice Address - Zip Code:20202
Practice Address - Country:EG
Practice Address - Phone:847-644-4656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000667106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist