Healthcare Provider Details

I. General information

NPI: 1174435168
Provider Name (Legal Business Name): AMINA FAARAH ABDULAALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 HORIZON DR
BURNSVILLE MN
55337-3091
US

IV. Provider business mailing address

2530 HORIZON DR
BURNSVILLE MN
55337-3091
US

V. Phone/Fax

Practice location:
  • Phone: 612-716-8019
  • Fax: 651-372-4200
Mailing address:
  • Phone: 612-716-8019
  • Fax: 651-372-4200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: