Individual
ABDIJALIL BASHI IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2642 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1032
(952) 232-8701
Mailing address
2642 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1032
(952) 232-8701
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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