Healthcare Provider Details

I. General information

NPI: 1114809860
Provider Name (Legal Business Name): HIKMO ISMAIL ABDIKADER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 08/20/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10273 YELLOW CIRCLE DRIVE
MINNETONKA MN
55343
US

IV. Provider business mailing address

1416 RUSSELL AVE N
MINNEAPOLIS MN
55411-2936
US

V. Phone/Fax

Practice location:
  • Phone: 952-401-9359
  • Fax:
Mailing address:
  • Phone: 612-423-4251
  • 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: