Abdifatah Yasin Abdi

Individual provider Active NPI Behavior Technician · Edina, MN

NPI 1760107965 · NPPES record last updated Oct 10, 2022

Key facts

NPI
1760107965
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
5245 Edina Industrial Blvd
Edina, MN 55439-2910
Phone
(612) 472-5645
Fax
(612) 886-2618
NPI assigned
Oct 10, 2022
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

5245 Edina Industrial Blvd
Edina, MN 55439-2910

Mailing address

5245 Edina Industrial Blvd
Edina, MN 55439-2910
Phone (612) 472-5645

Other providers in Edina, MN

All providers in Edina, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.