Individual
ABDIFATAR H ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1434 MARSHALL ST NE APT 209, MINNEAPOLIS, MN 55413-1076
(612) 387-8564
Mailing address
1434 MARSHALL ST NE APT 209, MINNEAPOLIS, MN 55413-1076
(612) 387-8564
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123
—
MN
Enumeration date
11/24/2022
Last updated
11/24/2022
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