Individual
AHMED OMAR HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1553 DALE ST N, SAINT PAUL, MN 55117-3411
(612) 432-2452
Mailing address
1553 DALE ST N, SAINT PAUL, MN 55117-3411
(612) 432-2452
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
491794
MN
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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