MEDICARE: ABDIRAHMAN 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
1	106S00000X	Behavior Technician		MN

General Provider Information

NPI Number	:	1881551117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDIRAHMAN ABDULLAHI

Provider Business Mailing Address
First Line	:	1505 SOUTHCROSS DR W STE 302
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55306-7015
Country	:	US
Telephone Number	:	612-427-5204
Fax Number	:	952-260-5070

Provider Business Practice Location Address
First Line	:	1505 SOUTHCROSS DR W STE 302
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55306-7015
Country	:	US
Telephone Number	:	612-427-5204
Fax Number	:	952-260-5070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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