Provider Demographics
NPI:1083488456
Name:FARAH, HAMSA
Entity Type:Individual
Prefix:
First Name:HAMSA
Middle Name:
Last Name:FARAH
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 1:14982 ECHO WAY
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-6479
Mailing Address - Country:US
Mailing Address - Phone:701-729-4836
Mailing Address - Fax:
Practice Address - Street 1:621 E 38TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-2571
Practice Address - Country:US
Practice Address - Phone:612-703-4094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst