Provider Demographics
NPI:1578328183
Name:HASSAN, FAUZIA
Entity Type:Individual
Prefix:
First Name:FAUZIA
Middle Name:
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 1:25 BRAINTREE PARK OFC PARK206
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-8702
Mailing Address - Country:US
Mailing Address - Phone:781-917-2320
Mailing Address - Fax:
Practice Address - Street 1:25 BRAINTREE PARK OFC PARK206
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-8702
Practice Address - Country:US
Practice Address - Phone:781-917-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor