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NPI Code Detail

MEDICARE: HANNA MOWLID MOHAMUD

MEDICARE: HANNA MOWLID MOHAMUD
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 : 1790442275
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNA MOWLID MOHAMUD
Provider Business Mailing Address
First Line : 9201 OLD CEDAR AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-2401
Country : US
Telephone Number : 952-854-1800
Fax Number :
Provider Business Practice Location Address
First Line : 9201 OLD CEDAR AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-2401
Country : US
Telephone Number : 952-854-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2021
Last Update Date : 11/19/2021

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Directions to “ HANNA MOWLID MOHAMUD ” Practice Location

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