Most Relevant Information
Provider Data
| NPI Number: | 1003416157 |
| Provider Name: | IBRAHIM ADAN NOOR |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/28/2020 |
| Last Updated: | 10/28/2020 |
Provider Practice Location
110 2ND ST S STE 202
WAITE PARK
MN
563871664
Practice Location Phone/Fax
| Phone: | 4255911935 |
| Fax: |
Provider Mailing Location
110 2ND ST S STE 202
WAITE PARK
MN
563871664
Provider Mailing Phone/Fax
| Phone: | 4255911935 |
| Fax: |