Provider Demographics
NPI:1326847161
Name:ELNOKRASHY, NEVEEN OSAMA
Entity type:Individual
Prefix:MRS
First Name:NEVEEN
Middle Name:OSAMA
Last Name:ELNOKRASHY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4162 GALLATIN LN APT B
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-1982
Mailing Address - Country:US
Mailing Address - Phone:314-489-4250
Mailing Address - Fax:
Practice Address - Street 1:4162 GALLATIN LN APT B
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-1982
Practice Address - Country:US
Practice Address - Phone:314-489-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORBT-22-202010106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician