Samiro Salah Abdi

Individual provider Active NPI Behavior Technician · Fridley, MN

NPI 1891521035 · NPPES record last updated Sep 13, 2024

Key facts

NPI
1891521035
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
7205 University Ave NE
Fridley, MN 55432-3134
Phone
(612) 298-7636
Fax
(612) 354-3801
NPI assigned
Sep 13, 2024
Sex
Female
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 MN Yes

Addresses

Primary practice location

7205 University Ave NE
Fridley, MN 55432-3134

Mailing address

1595 Sarazin St Apt 201
Shakopee, MN 55379-2539
Phone (612) 558-0175

Other providers in Fridley, MN

All providers in Fridley, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.