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NPI Code Detail

MEDICARE: SAMIRA ABDI

MEDICARE: SAMIRA ABDI
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
1103K00000XBehavior AnalystMN

General Provider Information

NPI Number : 1568181550
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMIRA ABDI
Provider Business Mailing Address
First Line : 1821 UNIVERSITY AVE W STE 181
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-2879
Country : US
Telephone Number : 612-259-7715
Fax Number :
Provider Business Practice Location Address
First Line : 1821 UNIVERSITY AVE W STE 181
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-2879
Country : US
Telephone Number : 612-259-7715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2022
Last Update Date : 08/24/2022

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Directions to “ SAMIRA ABDI ” Practice Location

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