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General NPI Number Information
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NPI Number | 1174398960
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Entity Type | Individual
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Provider Name | SADIA MOHAMED SHARIF
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Gender | Female
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 1380 ENERGY LN STE 201
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City | SAINT PAUL
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State | MN
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Zip | 55108-5253
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Country | US
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Telephone | 763-346-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 427 SNELLING AVE N APT 601
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City | SAINT PAUL
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State | MN
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Zip | 55104-3980
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Country | US
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Telephone | 612-559-5615
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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