Provider Demographics
NPI:1932647245
Name:BAHASSOUN, MUSLIMAH
Entity Type:Individual
Prefix:
First Name:MUSLIMAH
Middle Name:
Last Name:BAHASSOUN
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 1:8450 W CHARLESTON BLVD
Mailing Address - Street 2:2061
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-9015
Mailing Address - Country:US
Mailing Address - Phone:312-401-7076
Mailing Address - Fax:
Practice Address - Street 1:8450 W CHARLESTON BLVD
Practice Address - Street 2:2061
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-9010
Practice Address - Country:US
Practice Address - Phone:312-401-7076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst