Individual provider Active NPI

Amal Abdullahi Abdulle

  • Behavior Technician
  • Eden Prairie, MN
National Provider Identifier
1245195296
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
6385 Old Shady Oak Rd Ste 250
Eden Prairie, MN 55344-7705
Phone
(612) 394-4012
Fax
(651) 358-2604
NPI assigned
Dec 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MN Primary

Addresses

Primary practice location

6385 Old Shady Oak Rd Ste 250
Eden Prairie, MN 55344-7705

Mailing address

6385 Old Shady Oak Rd Ste 250
Eden Prairie, MN 55344-7705
Phone (612) 394-4012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1245195296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 OLD SHADY OAK RD STE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447705",
            "telephone_number": "612-394-4012",
            "fax_number": "651-358-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 OLD SHADY OAK RD STE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447705",
            "telephone_number": "612-394-4012",
            "fax_number": "651-358-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLE",
        "first_name": "AMAL",
        "middle_name": "ABDULLAHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.