Individual
BASHIR ABDIRISAQ AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 STINSON BLVD STE 314, MINNEAPOLIS, MN 55421-3424
(612) 298-7636
(612) 354-3801
Mailing address
500 122ND AVE NE, BLAINE, MN 55434-2651
(763) 306-3434
(612) 354-3801
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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