Provider Demographics
NPI:1447008123
Name:DHOORE, LADANE HASSAN
Entity type:Individual
Prefix:
First Name:LADANE
Middle Name:HASSAN
Last Name:DHOORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE S281
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2812
Mailing Address - Country:US
Mailing Address - Phone:161-229-8298
Mailing Address - Fax:
Practice Address - Street 1:1821 UNIVERSITY AVE W STE S281
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2812
Practice Address - Country:US
Practice Address - Phone:161-229-8298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306992101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor