Individual
MYMUNA YUSUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12369 5TH ST NE, BLAINE, MN 55434-2644
(612) 964-9551
Mailing address
12369 5TH ST NE, BLAINE, MN 55434-2644
(612) 964-9551
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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