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Individual

ABDILADIF HASSAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5722 UPPER 179TH ST W UPPR 179TH, LAKEVILLE, MN 55044-4931
(612) 978-0850
Mailing address
5722 UPPER 179TH ST W UPPR 179TH, LAKEVILLE, MN 55044-4931
(612) 978-0850

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
01/15/2024
Last updated
01/15/2024
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