Healthcare Provider Details

I. General information

NPI: 1770417099
Provider Name (Legal Business Name): UMAYMA M ABDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 4TH ST SE STE 202
SAINT CLOUD MN
56304-1371
US

IV. Provider business mailing address

1244 E SAINT GERMAIN ST APT 102
SAINT CLOUD MN
56304-0641
US

V. Phone/Fax

Practice location:
  • Phone: 320-217-8488
  • Fax: 320-281-5141
Mailing address:
  • Phone: 320-582-6478
  • 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: