Individual
NASTAHO MOHAMED ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 STAGECOACH RD UNIT 423, SHAKOPEE, MN 55379-8064
(507) 530-7077
Mailing address
145 HAMEL RD, MEDINA, MN 55340-9535
(612) 756-9107
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
N/A
MN
Enumeration date
01/09/2023
Last updated
09/05/2023
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