Individual
ABDIFATAH AHMED MAHAMOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55001 FELTL ROAD, MINNETONKA, MN 55343
(952) 746-0222
Mailing address
14301 EWING AVE S, BURNSVILLE, MN 55306-4885
(952) 746-5350
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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