Provider Demographics
NPI:1750739850
Name:GEBRAEL EL HACHEM, MONA EDWARD
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:EDWARD
Last Name:GEBRAEL EL HACHEM
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 1:47 W WYOMING AVE
Mailing Address - Street 2:8
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3767
Mailing Address - Country:US
Mailing Address - Phone:857-233-1821
Mailing Address - Fax:
Practice Address - Street 1:47 W WYOMING AVE
Practice Address - Street 2:8
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3767
Practice Address - Country:US
Practice Address - Phone:857-233-1821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling