Individual
FADUMO MOHAMED MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13841 APOLLO AVE, ROSEMOUNT, MN 55068-2172
(612) 242-0517
Mailing address
13841 APOLLO AVE, ROSEMOUNT, MN 55068-2172
(612) 242-0517
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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