Organization
SHINING LIGHT SKILL BUILDING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED CALI ADAM (ACCOUNT MANAGER)
(612) 978-0760
Entity
Organization
Contact information
Practice address
3055 OLD HIGHWAY 8 STE 106B, ST. ANTHONY, MN 55418
(612) 978-0760
Mailing address
3055 OLD HIGHWAY 8 STE 106B, ST. ANTHONY, MN 55418
(612) 978-0760
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
11/05/2020
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