Healthcare Provider Details

I. General information

NPI: 1912733619
Provider Name (Legal Business Name): HASSAN HAJIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 W DIVISION ST
SAINT CLOUD MN
56301-3822
US

IV. Provider business mailing address

2001 KILLEBREW DR STE 112
BLOOMINGTON MN
55425-1871
US

V. Phone/Fax

Practice location:
  • Phone: 952-212-0358
  • Fax: 612-326-6160
Mailing address:
  • Phone: 952-212-0358
  • Fax: 612-326-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: