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General NPI Number Information
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NPI Number | 1104556349
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Entity Type | Individual
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Provider Name | FARTUN A AHMED
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Gender | Female
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 06/11/2022
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Provider Practice Location Address
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Address Line | 2208 E 117TH ST
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City | BURNSVILLE
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State | MN
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Zip | 55337-1265
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Country | US
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Telephone | 952-297-5333
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Fax | 952-513-7963
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Provider Business Mailing Address
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Address Line | 2208 E 117TH ST
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City | BURNSVILLE
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State | MN
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Zip | 55337-1265
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Country | US
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Telephone | 952-297-5333
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Fax | 952-513-7963
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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