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NPI Code Detail

MEDICARE: ABDI ADAN ALI

MEDICARE: ABDI ADAN ALI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1174119200
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABDI ADAN ALI
Provider Business Mailing Address
First Line : 6385 OLD SHADY OAK RD STE 250
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7705
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6385 OLD SHADY OAK RD STE 250
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7705
Country : US
Telephone Number : 612-226-0907
Fax Number : 612-564-7604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2020
Last Update Date : 12/13/2020

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Directions to “ ABDI ADAN ALI ” Practice Location

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