Individual
ABDIRIZAK BASHIR MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
432 GATEWAY BLVD, BURNSVILLE, MN 55337-2559
(612) 707-2279
Mailing address
432 GATEWAY BLVD, BURNSVILLE, MN 55337-2559
(952) 994-4835
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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