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1730742172
FARDOWSA HASSAN IMAN
SAINT CLOUD, MN
NPI
1730742172
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 305423)
Enumeration Date
2019-04-22
Last Update Date
2019-05-20
Business Address
FARDOWSA HASSAN IMAN LADC
524 25TH AVE N
SAINT CLOUD, MN 56303-3255
Phone number: 320-202-1909
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Mailing Address
FARDOWSA HASSAN IMAN LADC
524 25TH AVE N
SAINT CLOUD, MN 56303-3255
Phone number: 320-202-1909
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