Individual
ABDIFATAH MOHAMED ABDULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12790 PRIMROSE LN APT 303, EDEN PRAIRIE, MN 55344-7633
(320) 557-6259
Mailing address
12790 PRIMROSE LN APT 303, EDEN PRAIRIE, MN 55344-7633
(320) 557-6259
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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