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Organization

ABA BEHAVIORAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FATHI MOHAMUD MOHAMED (CEO)
(202) 779-1350
Entity
Organization

Contact information

Practice address
2719 W DIVISION ST STE 107, SAINT CLOUD, MN 56301-3409
(202) 779-1350
Mailing address
2719 W DIVISION ST STE 107, SAINT CLOUD, MN 56301-3409

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
06/15/2023
Last updated
06/15/2023
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