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General NPI Number Information
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NPI Number | 1043750078
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Entity Type | Individual
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Provider Name | AYOUB NIGATU MA
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Gender | Male
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 1437 MARSHALL AVE STE 102
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City | SAINT PAUL
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State | MN
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Zip | 55104-6345
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Country | US
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Telephone | 651-329-6171
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Fax |
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Provider Business Mailing Address
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Address Line | 1437 MARSHALL AVE STE 102
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City | SAINT PAUL
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State | MN
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Zip | 55104-6345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | MN
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