Provider Demographics
NPI:1255822698
Name:HOSAINI, AMINA
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:HOSAINI
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 1:60 MILLER FARMS RD
Mailing Address - Street 2:
Mailing Address - City:WILLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06279-2128
Mailing Address - Country:US
Mailing Address - Phone:860-576-8343
Mailing Address - Fax:
Practice Address - Street 1:60 MILLER FARMS RD
Practice Address - Street 2:
Practice Address - City:WILLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06279-2128
Practice Address - Country:US
Practice Address - Phone:860-768-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT42011041C0700X
CT110011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical