Individual
ISHWAQ YUSUF MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2958 VANDERBIE ST, SAINT PAUL, MN 55117-1225
(206) 468-4882
Mailing address
2958 VANDERBIE ST, SAINT PAUL, MN 55117-1225
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/24/2025
Last updated
06/02/2025
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