Individual
FALLIS SIYAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2614 NICOLLET AVE STE 209, MINNEAPOLIS, MN 55408-1628
(612) 354-3995
Mailing address
2614 NICOLLET AVE STE 209, MINNEAPOLIS, MN 55408-1628
(612) 354-3995
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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