Provider Demographics
NPI:1063248375
Name:HASSAN, HAMDI OMAR
Entity type:Individual
Prefix:
First Name:HAMDI
Middle Name:OMAR
Last Name:HASSAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 JOLLY LN NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-5049
Mailing Address - Country:US
Mailing Address - Phone:612-806-8286
Mailing Address - Fax:
Practice Address - Street 1:336 JOLLY LN NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-5049
Practice Address - Country:US
Practice Address - Phone:612-806-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health