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General NPI Number Information
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NPI Number | 1154116994
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Entity Type | Individual
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Provider Name | AHMED MOHAMOUD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 7800 METRO PKWY STE 200
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1506
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Country | US
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Telephone | 612-387-3541
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Fax |
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Provider Business Mailing Address
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Address Line | 3947 VALLEY VIEW DR S APT 206
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City | EAGAN
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State | MN
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Zip | 55122-1546
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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