Healthcare Provider Details

I. General information

NPI: 1518727551
Provider Name (Legal Business Name): ABDIRHMAN SAID ABDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SUPERIOR DR NW
ROCHESTER MN
55901-1774
US

IV. Provider business mailing address

2569 GEORGETOWNE PL NW
ROCHESTER MN
55901-7028
US

V. Phone/Fax

Practice location:
  • Phone: 612-326-6160
  • Fax:
Mailing address:
  • Phone: 507-202-5052
  • 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: