Healthcare Provider Details

I. General information

NPI: 1225950876
Provider Name (Legal Business Name): SAADIA BASHIR AIDID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 DOUGLAS DR N STE 107
GOLDEN VALLEY MN
55422-4397
US

IV. Provider business mailing address

505 HUMBOLDT AVE N APT 304
MINNEAPOLIS MN
55405-1357
US

V. Phone/Fax

Practice location:
  • Phone: 612-701-7375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: