Individual
DEEQAIFRAH A HUSSEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3055 OLD HIGHWAY 8 STE 101D, ST ANTHONY, MN 55418-2500
(612) 367-4153
(612) 259-8361
Mailing address
1712 129TH AVE NE, BLAINE, MN 55449-6264
(612) 384-6156
(612) 259-8361
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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