Individual
KAUSAR JAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 857-1519
Mailing address
1805 LACOTA LN, BURNSVILLE, MN 55337-2391
(952) 261-4907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363A00000X
Physician Assistant
Primary
—
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/25/2021
Last updated
10/26/2023
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