Provider Demographics
NPI:1447974688
Name:MURSAL, ASHA ARAB
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:ARAB
Last Name:MURSAL
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 1:1801 W 80 1/2 ST UNIT 339
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-7102
Mailing Address - Country:US
Mailing Address - Phone:619-576-6009
Mailing Address - Fax:
Practice Address - Street 1:1801 W 80 1/2 ST UNIT 339
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-7102
Practice Address - Country:US
Practice Address - Phone:619-576-6009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty