Provider Demographics
NPI:1235947987
Name:HASHI, BALQIIS SAKARIYE (N/A)
Entity type:Individual
Prefix:MS
First Name:BALQIIS
Middle Name:SAKARIYE
Last Name:HASHI
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:MS
Other - First Name:BALQIIS
Other - Middle Name:
Other - Last Name:HASSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2205 SHENANDOAH LN N
Mailing Address - Street 2:APT 110
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447
Mailing Address - Country:US
Mailing Address - Phone:612-453-5452
Mailing Address - Fax:
Practice Address - Street 1:100 N PACIFIC COAST HWY FL 14
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4359
Practice Address - Country:US
Practice Address - Phone:424-309-8747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician