MEDICARE: SUCDI HUSSEIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst		MN

General Provider Information

NPI Number	:	1225992456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUCDI HUSSEIN

Provider Business Mailing Address
First Line	:	3606 DENMARK AVE
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55123-1046
Country	:	US
Telephone Number	:	952-242-5975
Fax Number	:	952-242-5975

Provider Business Practice Location Address
First Line	:	3606 DENMARK AVE
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55123-1046
Country	:	US
Telephone Number	:	952-242-5975
Fax Number	:	952-242-5975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ SUCDI HUSSEIN ” Practice Location

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