Provider Demographics
NPI:1194099168
Name:HUSSAIN, YUSRA
Entity type:Individual
Prefix:
First Name:YUSRA
Middle Name:
Last Name:HUSSAIN
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 1:122 RAWSON RD
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-2045
Mailing Address - Country:US
Mailing Address - Phone:781-510-2030
Mailing Address - Fax:
Practice Address - Street 1:30 STATE ST
Practice Address - Street 2:MAY INSTITUTE
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3219
Practice Address - Country:US
Practice Address - Phone:781-986-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health