Individual
FARDOSA AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8427 KNOX AVE S, BLOOMINGTON, MN 55431-1760
(619) 793-6154
Mailing address
8427 KNOX AVE S, BLOOMINGTON, MN 55431-1760
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
01/22/2024
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