Individual
IMAN AL SUDANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1613 PROSPECT PARK WAY STE 110, FORT COLLINS, CO 80525-9707
(970) 377-9401
Mailing address
3450 LOST LAKE PL UNIT H4, FORT COLLINS, CO 80528-7055
(970) 294-4129
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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