Individual
ABDI DEROW MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 SOUTHCROSS DR W, BURNSVILLE, MN 55306-6938
(952) 456-1474
Mailing address
1501 SOUTHCROSS DR W, BURNSVILLE, MN 55306-6938
(952) 456-1474
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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