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General NPI Number Information
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NPI Number | 1689498677
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Entity Type | Individual
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Provider Name | SUHAYB MOHAMED ALI
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Gender | Male
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 603 E 138TH ST
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City | BURNSVILLE
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State | MN
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Zip | 55337-4163
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Country | US
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Telephone | 952-388-8002
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Fax | 952-600-4013
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Provider Business Mailing Address
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Address Line | 2748 E 82ND ST
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1365
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Country | US
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Telephone | 952-600-4009
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Fax | 952-600-4013
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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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