Individual
FADUMO ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(763) 742-9250
Mailing address
2424 12TH AVE S, MINNEAPOLIS, MN 55404-3808
(763) 742-9250
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306343
MN
101YM0800X
Mental Health Counselor
Primary
4450
MN
Other
Enumeration date
04/19/2022
Last updated
08/09/2024
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