Provider Information for 1588780555
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Ms. FAIZAH ANN MAWUSI LCSW
Other Names:Former Name:DEBRA ANN WELLS LCSWSex: Female
NPI: 1588780555
Last Updated: 2024-12-23
Certification Date: 2024-12-23
Certification Date: 2024-12-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1588780555 | ||||||||
| Enumeration Date | 2007-03-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2025 N DREXEL AVE INDIANAPOLIS, IN 46218-4559 United States Phone: 317-250-0370 | Fax: | ||||||||
| Primary Practice Address | 2025 N DREXEL AVE INDIANAPOLIS, IN 46218-4559 United States Phone: 317-250-0370 | Fax: | ||||||||
| Secondary Practice Address(es) | 8401 HARCOURT RD | ||||||||
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