Most Relevant Information
Provider Data
| NPI Number: | 1003647330 |
| Provider Name: | ABDINASIR ABDIKARIM HASSAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/08/2024 |
| Last Updated: | 08/08/2024 |
Provider Practice Location
5722 UPPER 179TH ST W UPPR 179TH
LAKEVILLE
MN
550444931
Practice Location Phone/Fax
| Phone: | 6129780850 |
| Fax: |
Provider Mailing Location
5722 UPPER 179TH ST W UPPR 179TH
LAKEVILLE
MN
550444931
Provider Mailing Phone/Fax
| Phone: | 6129780850 |
| Fax: |