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Individual

BASRA AWGEYDHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2400 BLAISDELL AVE STE 203, MINNEAPOLIS, MN 55404-3331
(612) 895-9646
Mailing address
2400 BLAISDELL AVE STE 203, MINNEAPOLIS, MN 55404-3331

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/14/2025
Last updated
05/14/2025
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