Provider Demographics
NPI:1659191310
Name:HASSAN, BRANDON (MT-BC, NMT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:HASSAN
Suffix:
Gender:U
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:MOWGLI
Other - Middle Name:
Other - Last Name:HASSAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MT-BC, NMT
Mailing Address - Street 1:PO BOX 2203
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-2203
Mailing Address - Country:US
Mailing Address - Phone:617-651-1706
Mailing Address - Fax:
Practice Address - Street 1:10 E FEDERAL ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117
Practice Address - Country:US
Practice Address - Phone:972-322-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist