Individual
ANTU MUKHTAR MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7205 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3134
(612) 298-7636
(612) 354-3801
Mailing address
5400 BRYANT AVE N, MINNEAPOLIS, MN 55430-3115
(763) 516-8979
(612) 354-3801
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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