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NPI Code Detail

MEDICARE: QADRA OMAR ABDULLAHI

MEDICARE: QADRA OMAR ABDULLAHI
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417800558
Entity Type Code : Individual
Provider Name (Legal Business Name) : QADRA OMAR ABDULLAHI
Provider Business Mailing Address
First Line : 3341 W SAINT GERMAIN ST STE 101
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-7315
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3341 W SAINT GERMAIN ST STE 101
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-7315
Country : US
Telephone Number : 320-281-3037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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Directions to “ QADRA OMAR ABDULLAHI ” Practice Location

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