Provider Demographics
NPI:1134889058
Name:HASANOVIC, ADINA
Entity type:Individual
Prefix:
First Name:ADINA
Middle Name:
Last Name:HASANOVIC
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 1:170 BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-2901
Mailing Address - Country:US
Mailing Address - Phone:203-815-6256
Mailing Address - Fax:
Practice Address - Street 1:15 SUMMIT PL
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1034
Practice Address - Country:US
Practice Address - Phone:860-906-2766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor