Basic Information
| Provider Information | |||||||||
| NPI: | 1285718163 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASSAN | ||||||||
| FirstName: | RAKHSHANDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1032 CROSSWINDS CT | ||||||||
| Address2: | |||||||||
| City: | WENTZVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633854836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363326000 | ||||||||
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| Practice Location | |||||||||
| Address1: | ST LOUIS PSYCHIATRIC REHABILITATION CENTER | ||||||||
| Address2: | 5300 ARSENAL | ||||||||
| City: | ST LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148775989 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | R7G40 | MO | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0804X | R7G40 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.