Provider Demographics
NPI:1578332276
Name:ADAN, HAMDI FARAH
Entity type:Individual
Prefix:
First Name:HAMDI
Middle Name:FARAH
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 1:1400 PARKVIEW LN NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2439
Mailing Address - Country:US
Mailing Address - Phone:612-545-7231
Mailing Address - Fax:
Practice Address - Street 1:1400 PARKVIEW LN NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-2439
Practice Address - Country:US
Practice Address - Phone:612-545-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician