Individual
FARTUN AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
16020 TEMPLE DR, MINNETONKA, MN 55345-3422
(612) 845-9692
(952) 223-6155
Mailing address
715 9TH AVE S, HOPKINS, MN 55343-7708
(612) 481-8502
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305005
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305005
STATE OF MINNESTOA
MN
Enumeration date
02/21/2018
Last updated
02/21/2018
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