Individual
ANISA SOPHIA MOHAMMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
200 4TH AVE W, #300, SHAKOPEE, MN 55379-1220
(952) 496-8614
Mailing address
200 4TH AVE W, #300, SHAKOPEE, MN 55379-1220
(952) 496-8614
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5667
MN
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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