Provider Demographics
NPI:1750088621
Name:HASSEN, JOY A
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:A
Last Name:HASSEN
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 1:450 COUNTY ROAD 108
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-9735
Mailing Address - Country:US
Mailing Address - Phone:419-680-4975
Mailing Address - Fax:
Practice Address - Street 1:450 COUNTY ROAD 108
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-9735
Practice Address - Country:US
Practice Address - Phone:419-680-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHBG1OO6706103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities