Individual
DEQO M FARAH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2021 E HENNEPIN AVE, ST LL20, MINNEAPOLIS, MN 55113
(612) 259-7711
(612) 259-7711
Mailing address
2021 E HENNEPIN AVE STR LL20, MINNEAPOLIS, MN 55113
(612) 259-7711
(612) 259-7711
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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