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NPI Code Detail

MEDICARE: SUMAYA ABDIRASHID MOHAMED

MEDICARE:   SUMAYA ABDIRASHID MOHAMED
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1578297008
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUMAYA ABDIRASHID MOHAMED
Provider Business Mailing Address
First Line : 7835 3RD ST N STE 108
Second Line :
City : OAKDALE
State : MN
Zip : 55128-5445
Country : US
Telephone Number : 651-666-1267
Fax Number : 651-666-1268
Provider Business Practice Location Address
First Line : 7835 3RD ST N STE 108
Second Line :
City : OAKDALE
State : MN
Zip : 55128-5445
Country : US
Telephone Number : 651-666-1267
Fax Number : 651-666-1268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2022
Last Update Date : 07/11/2022

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Directions to “ SUMAYA ABDIRASHID MOHAMED ” Practice Location

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