Provider Demographics
NPI:1932911492
Name:HASSAN, JAAFAR ALINUR
Entity type:Individual
Prefix:
First Name:JAAFAR
Middle Name:ALINUR
Last Name:HASSAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 DAKOTA DR
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1266
Mailing Address - Country:US
Mailing Address - Phone:651-214-8982
Mailing Address - Fax:
Practice Address - Street 1:1044 DAKOTA DR
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1266
Practice Address - Country:US
Practice Address - Phone:651-214-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician