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NPI Code Detail

MEDICARE: SUHAYLA FARXAN MOHAMUD

MEDICARE: SUHAYLA FARXAN MOHAMUD
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
1101YM0800XMental Health Counselor
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1619693553
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUHAYLA FARXAN MOHAMUD
Provider Business Mailing Address
First Line : 8937 AZTEC DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55347-2635
Country : US
Telephone Number : 952-529-8769
Fax Number : 612-545-0101
Provider Business Practice Location Address
First Line : 8937 AZTEC DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55347-2635
Country : US
Telephone Number : 952-529-8769
Fax Number : 612-545-0101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2022
Last Update Date : 07/23/2025

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Directions to “ SUHAYLA FARXAN MOHAMUD ” Practice Location

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