Individual
MOHAMED MOHAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11972 PORTLAND AVE, BURNSVILLE, MN 55337-1516
(952) 658-8670
Mailing address
187 CAPITOL VW # 187, ROSEVILLE, MN 55113-4732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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