Individual
ANISA ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1817 NICOLLET AVE, MINNEAPOLIS, MN 55403-3774
(612) 354-9956
Mailing address
1817 NICOLLET AVENUE S STE, MINNEAPOLIS, MN 55403
(612) 354-9956
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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