Individual
ABDIFITAH M MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 NEW BRIGHTON BLVD, SUITE 110, SAINT ANTHONY, MN 55418
(651) 428-3783
Mailing address
2500 NEW BRIGHTON BLVD, SUITE 110, SAINT ANTHONY, MN 55418
(651) 428-3783
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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