Individual
FAIZA HASSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10917 HUMBOLDT AVE S, BLOOMINGTON, MN 55431-4221
(651) 315-2649
Mailing address
10917 HUMBOLDT AVE S, BLOOMINGTON, MN 55431-4221
(651) 315-2649
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
0015858
WI
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MN
Other
Enumeration date
03/28/2016
Last updated
03/17/2018
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