Provider Demographics
NPI:1528880044
Name:HOSSAIN, JAHANARA
Entity type:Individual
Prefix:
First Name:JAHANARA
Middle Name:
Last Name:HOSSAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JAHANARA
Other - Middle Name:
Other - Last Name:HOSSAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BT
Mailing Address - Street 1:2669 BULLION LOOP
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5803
Mailing Address - Country:US
Mailing Address - Phone:407-417-3935
Mailing Address - Fax:
Practice Address - Street 1:305 WAYMONT CT STE 101
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3566
Practice Address - Country:US
Practice Address - Phone:407-731-0940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician