Individual
FARDOSA HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 STINSON BLVD STE 314, MINNEAPOLIS, MN 55421-3424
(612) 298-7636
(612) 354-3801
Mailing address
4001 STINSON BLVD STE 314, MINNEAPOLIS, MN 55421-3424
(612) 298-7636
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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