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MARK SHOUKRY ASHAMALLA MHW

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1922385806

Individual Registrant:
 MARK SHOUKRY ASHAMALLA MHW
Gender: M
Not Sole Proprietor

Location and contact information for practice:
401 E CYPRESS AVE  LOMPOC, CA 93436-6806 US
Tel: 805-865-1940  Fax: 805-865-1954

Contact information for business:
401 E CYPRESS AVE  LOMPOC, CA 93436-6806 US
Tel: 805-865-1940  Fax: 805-865-1954

Registration Information:
NPI: 1922385806
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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