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Individual
ALHASAN BASSAM
Active
Individual
ALHASAN BASSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y3404397
MAXIM HEALTH CARE
CA
Enumeration date
06/25/2022
Last updated
06/25/2022
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