Provider Demographics
NPI:1598527384
Name:JAMA, NASRA
Entity Type:Individual
Prefix:
First Name:NASRA
Middle Name:
Last Name:JAMA
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 1:1701 AMERICAN BLVD E STE 19
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1401
Mailing Address - Country:US
Mailing Address - Phone:952-212-0358
Mailing Address - Fax:
Practice Address - Street 1:1701 AMERICAN BLVD E STE 19
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1401
Practice Address - Country:US
Practice Address - Phone:952-212-0358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health