Provider Demographics
NPI:1700539855
Name:QASEM, NORHAN
Entity type:Individual
Prefix:
First Name:NORHAN
Middle Name:
Last Name:QASEM
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 1:2600 FERNBROOK LN N STE 138
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-4752
Mailing Address - Country:US
Mailing Address - Phone:952-544-0349
Mailing Address - Fax:844-795-7474
Practice Address - Street 1:9702 MILL CREEK DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-4307
Practice Address - Country:US
Practice Address - Phone:952-564-9264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician