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Individual

AYAN MAHAMUD MOHAMED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4001 STINSON BLVD NE STE 314, MINNEAPOLIS, MN 55421-3424
(612) 298-7636
(612) 354-3801
Mailing address
8227 12TH AVE S, BLOOMINGTON, MN 55425-1709
(612) 232-9113
(612) 354-3801

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MN

Other

Enumeration date
07/11/2022
Last updated
07/11/2022
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