Organization
PRIME AUTISM CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAFICI D ALI (PRESIDENT)
(612) 900-2854
Entity
Organization
Contact information
Practice address
322 W LAKE ST STE 207, MINNEAPOLIS, MN 55408-5202
(612) 900-2854
Mailing address
322 W LAKE ST STE 207, MINNEAPOLIS, MN 55408-5202
(612) 900-2854
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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