Provider Demographics
NPI:1598550295
Name:EL-HAJ, MARIAM
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:EL-HAJ
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 1:1240 E BUSINESS HIGHWAY 83 STE B
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9617
Mailing Address - Country:US
Mailing Address - Phone:956-624-5385
Mailing Address - Fax:
Practice Address - Street 1:3711 TINSLEY AVE APT 4
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3855
Practice Address - Country:US
Practice Address - Phone:956-624-5385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94646101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional