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Individual

ASHA HAMUD HERSI I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7205 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3134
(612) 208-0729
(612) 354-3801
Mailing address
4624 FILLMORE ST NE, COLUMBIA HEIGHTS, MN 55421-2446
(612) 814-2651

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MN

Other

Enumeration date
11/08/2022
Last updated
11/08/2022
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