Healthcare Provider Details

I. General information

NPI: 1750147641
Provider Name (Legal Business Name): ZAHUR M ABDULLAHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 WAYZATA BLVD STE 700
ST LOUIS PARK MN
55416-1233
US

IV. Provider business mailing address

5775 WAYZATA BLVD STE 700
ST LOUIS PARK MN
55416-1233
US

V. Phone/Fax

Practice location:
  • Phone: 763-312-1878
  • Fax:
Mailing address:
  • Phone: 763-312-1878
  • 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: