Individual
FADUMO AHMED MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 BROADWAY ST NE STE 120, MINNEAPOLIS, MN 55413-1253
(612) 323-1871
Mailing address
1919 BROADWAY ST NE STE 120, MINNEAPOLIS, MN 55413-1253
(612) 323-1817
(612) 656-0203
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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