Provider Demographics
NPI:1053147975
Name:ADAN, FAHIMA HUSSEIN
Entity type:Individual
Prefix:
First Name:FAHIMA
Middle Name:HUSSEIN
Last Name:ADAN
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 1:1716 8 1/2 ST SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4983
Mailing Address - Country:US
Mailing Address - Phone:507-319-3102
Mailing Address - Fax:
Practice Address - Street 1:29 7TH AVE NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-4666
Practice Address - Country:US
Practice Address - Phone:507-319-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst