Individual
AISHA MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7205 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3134
(612) 298-7636
(612) 354-3801
Mailing address
2286 COUNTY ROAD D E, SAINT PAUL, MN 55109-5319
(651) 235-6119
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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