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General NPI Number Information
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NPI Number | 1992568752
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Entity Type | Individual
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Provider Name | MR. ABDIMANAN MOHAMED HIRSI SR.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 925 30TH AVE S APT 305
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-1159
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Country | US
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Telephone | 763-496-8725
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Fax |
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Provider Business Mailing Address
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Address Line | 925 30TH AVE S APT 305
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-1159
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Country | US
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Telephone | 763-496-8725
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | H6200139809407
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License Number State | WI
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