Organization
ABC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YASMIN AWAD B.A (OWNER)
(206) 432-0809
Entity
Organization
Contact information
Practice address
2833 13TH AVE S STE 219, MINNEAPOLIS, MN 55407-1417
(206) 432-0809
Mailing address
2833 13TH AVE S STE 219, MINNEAPOLIS, MN 55407-1417
(206) 432-0809
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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