Individual
DEKA FARAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2151 NORTHDALE BLVD NW, COON RAPIDS, MN 55433-3006
(612) 408-6638
Mailing address
4138 LEXINGTON AVE N APT 3313, SHOREVIEW, MN 55126-6137
(612) 707-3202
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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