Individual
AWIL MOHAMED OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LEVEL ONE PROVIDER
Contact information
Practice address
2208 E 117TH ST, BURNSVILLE, MN 55337-1265
(612) 447-2381
Mailing address
2208 E 117TH ST, BURNSVILLE, MN 55337-1265
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/06/2024
Last updated
07/06/2024
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