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NPI Code Detail

MEDICARE: TUFAH HASSEN I

MEDICARE:   TUFAH  HASSEN I
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
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianB000-053-697-100MN

General Provider Information

NPI Number : 1184402828
Entity Type Code : Individual
Provider Name (Legal Business Name) : TUFAH HASSEN I
Provider Business Mailing Address
First Line : 145 ARLINGTON AVE E
Second Line :
City : SAINT PAUL
State : MN
Zip : 55117-3905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 145 ARLINGTON AVE E
Second Line :
City : SAINT PAUL
State : MN
Zip : 55117-3905
Country : US
Telephone Number : 612-441-8375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2023
Last Update Date : 09/14/2023

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Directions to “ TUFAH HASSEN I ” Practice Location

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