Healthcare Provider Details

I. General information

NPI: 1619601648
Provider Name (Legal Business Name): SAADIA OLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 PORTLAND AVE APT 2
MINNEAPOLIS MN
55404-2660
US

IV. Provider business mailing address

2115 PORTLAND AVE APT 2
MINNEAPOLIS MN
55404-2660
US

V. Phone/Fax

Practice location:
  • Phone: 763-606-2136
  • Fax:
Mailing address:
  • Phone: 763-606-2136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: