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Individual

ABDIGANI ALI IDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4911 77TH ST W APT 501, EDINA, MN 55435-4840
(763) 600-4133
(866) 635-1990
Mailing address
4911 77TH ST W APT 501, EDINA, MN 55435-4840
(763) 600-4133
(866) 635-1990

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/24/2024
Last updated
06/24/2024
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