Basic Information
| Provider Information | |||||||||
| NPI: | 1376751362 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASAN | ||||||||
| FirstName: | TAUHEED | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MA, LPC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 ELDON BAKER DR | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485071923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102322766 | ||||||||
| FaxNumber: | 8102322782 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 ELDON BAKER DR | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485071923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102322766 | ||||||||
| FaxNumber: | 8102322782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 08/03/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401014937 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.