Individual ProviderIfrah AliCounselorBehavioral Health & Social Service ProvidersPractice Address3600 Mystic Valley Pkwy, Apt W612, Medford, MA 02155-5733(404) 403-1717PECOS EnrollmentBased on the most recent information from CMS, provider Ifrah Ali does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1922324524Provider TypeIndividualFull NameAli, IfrahCredentialB.A.GenderFemaleSole ProprietorNoEnumeration Date4/8/2010Last Updated4/8/2010Contact InformationPractice LocationPractice Address3600 Mystic Valley Pkwy, Apt W612, Medford, MA 02155-5733Phone(404) 403-1717FaxUnlisted FaxMailing LocationMailing Address3600 Mystic Valley Pkwy, Apt W612, Medford, MA 02155-5733PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer