| Doctor Name: | MS. ESRA AHMED |
| NPI Number: | 1144545062 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 1070 |
| Business Practice Address: | 6810 Crumpler Blvd Olive Branch, MS - 386541933 |
| Business Phone Number: | 9014097560 |
| Business Fax Number: | 6628900622 |
| Mailing Address: | 6810 Crumpler Blvd, OLIVE BRANCH |
| State: | MS |
| Postal Code: | 386541933 |
| Phone Number: | 9014097560 |
| Fax Number: | 6628900622 |
| NPI Enumeration Date: | 04/03/2010 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1070 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |