MEDICARE: HODON ALI YUSSUF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	A568684300	MN

General Provider Information

NPI Number	:	1003763293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HODON ALI YUSSUF

Provider Business Mailing Address
First Line	:	6725 YORK AVE S APT 437
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-3231
Country	:	US
Telephone Number	:	952-522-0550
Fax Number	:	952-600-1996

Provider Business Practice Location Address
First Line	:	11485 VALLEY VIEW RD
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3617
Country	:	US
Telephone Number	:	952-522-0550
Fax Number	:	952-600-1996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ HODON ALI YUSSUF ” Practice Location

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