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NPI Code Detail

MEDICARE: FAISA HUSSEN

MEDICARE: FAISA HUSSEN
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

General Provider Information

NPI Number : 1265297519
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAISA HUSSEN
Provider Business Mailing Address
First Line : 1973 SLOAN PL STE 100
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55117-2085
Country : US
Telephone Number : 612-309-1918
Fax Number :
Provider Business Practice Location Address
First Line : 1973 SLOAN PL STE 100
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55117-2085
Country : US
Telephone Number : 612-309-1918
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2024
Last Update Date : 02/15/2024

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Directions to “ FAISA HUSSEN ” Practice Location

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