Individual
ABDIASIS MOHAMED SIAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 DIVISION ST, WAITE PARK, MN 56387-1330
(612) 735-6673
Mailing address
110 DIVISION ST, WAITE PARK, MN 56387-1330
(612) 735-6673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/04/2024
Last updated
05/04/2024
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