Individual
FARDOWSA AHMED HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 204-7009
Mailing address
5951 UNIVERSITY AVE NE APT 421, FRIDLEY, MN 55432-2886
(612) 242-4098
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305947
MN
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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