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Individual

MOUSTAPHA OMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1406 19TH ST SE, SAINT CLOUD, MN 56304-4661
(612) 636-5139
Mailing address
1406 19TH ST SE, SAINT CLOUD, MN 56304-4661

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
10/16/2023
Last updated
10/16/2023
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