Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 3083-A | NC |
NPI | 1003160490 |
---|---|
Provider Name | Annie Rasheedah Hasan |
First Address | Fayetteville, NC 28311-1203 |
Second Address | Fayetteville, NC 28311-1203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2012 |
Last Update Date | 06/11/2012 |