Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003406240 |
---|---|
Provider Name | Nima Abdullahi Hassan |
First Address | St Anthony, MN 55418-2500 |
Second Address | St Anthony, MN 55418-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2021 |
Last Update Date | 21/01/2021 |