Individual
ATHARA ISMAIL IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/AUD
Contact information
Practice address
4801 W 81ST ST STE 112, BLOOMINGTON, MN 55437-1111
(952) 345-3000
(952) 345-6789
Mailing address
4801 W 81ST ST STE 112, BLOOMINGTON, MN 55437-1111
(952) 345-3000
(952) 345-6789
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
528789
MN
Other
Enumeration date
07/21/2023
Last updated
11/14/2025
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