Organization
PROACTIVE AUTISM THERAPY
Active
Other names
Proactive Autism Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ABDI HUSSEIN (OWNER/MANAGER)
(612) 384-6156
Entity
Organization
Contact information
Practice address
1712 129TH AVE NE, BLAINE, MN 55449-6264
(612) 384-6156
Mailing address
1712 129TH AVE NE, BLAINE, MN 55449-6264
(612) 384-6156
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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