Provider Demographics
NPI:1427647023
Name:ISAH, AISHA-ELIZABETH (MS, MPHIL)
Entity type:Individual
Prefix:
First Name:AISHA-ELIZABETH
Middle Name:
Last Name:ISAH
Suffix:
Gender:F
Credentials:MS, MPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 MCCALLUM ST APT A104
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3130
Mailing Address - Country:US
Mailing Address - Phone:267-323-6024
Mailing Address - Fax:
Practice Address - Street 1:6635 MCCALLUM ST APT A104
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-3130
Practice Address - Country:US
Practice Address - Phone:484-393-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008963101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor