Individual
AYUB MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11972 PORTLAND AVE, BURNSVILLE, MN 55337-1516
(952) 658-8670
Mailing address
11972 PORTLAND AVE, BURNSVILLE, MN 55337-1516
(952) 658-8670
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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