MEDICARE: KOWTHAR A ABSHIR

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

General Provider Information

NPI Number	:	1770351751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOWTHAR A ABSHIR

Provider Business Mailing Address
First Line	:	2205 NICOLLET AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8754 STRATFORD XING
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-3841
Country	:	US
Telephone Number	:	612-423-8306
Fax Number	:

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

Provider Enumeration Date	:	12/19/2023
Last Update Date	:	12/19/2023

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Directions to “ KOWTHAR A ABSHIR ” Practice Location

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