Provider Demographics
NPI:1174203277
Name:FARKHUDIN, HALIMA AMIN
Entity type:Individual
Prefix:
First Name:HALIMA
Middle Name:AMIN
Last Name:FARKHUDIN
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 1:13800 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-6755
Mailing Address - Country:US
Mailing Address - Phone:507-213-3889
Mailing Address - Fax:
Practice Address - Street 1:2300 N CEDAR AVE APT C14
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-5403
Practice Address - Country:US
Practice Address - Phone:507-213-3889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst