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NPI Code Detail

MEDICARE: AMAL A HASSAN

MEDICARE:   AMAL A HASSAN
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1962164129
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMAL A HASSAN
Provider Business Mailing Address
First Line : 2907 CLEARWATER RD STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-6191
Country : US
Telephone Number : 320-237-6571
Fax Number : 320-205-0930
Provider Business Practice Location Address
First Line : 2907 CLEARWATER RD STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-6191
Country : US
Telephone Number : 320-237-6571
Fax Number : 320-205-0930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2021
Last Update Date : 10/05/2021

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Directions to “ AMAL A HASSAN ” Practice Location

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