Provider Demographics
NPI:1619623030
Name:HASAN, SUNEHRA (BEHAVIOR THERAPIST)
Entity Type:Individual
Prefix:
First Name:SUNEHRA
Middle Name:
Last Name:HASAN
Suffix:
Gender:F
Credentials:BEHAVIOR THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 SPARTINA RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4960
Mailing Address - Country:US
Mailing Address - Phone:630-618-7939
Mailing Address - Fax:
Practice Address - Street 1:2508 SPARTINA RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4960
Practice Address - Country:US
Practice Address - Phone:630-618-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No251C00000XAgenciesDay Training, Developmentally Disabled Services