Individual
FARDOSA ABDULLAH FARAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10650 RED CIRCLE DR STE 320, MINNETONKA, MN 55343-9117
(612) 987-3455
Mailing address
6265 MONTICELLO LN N, MAPLE GROVE, MN 55369-6285
(612) 707-0477
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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