Provider Demographics
NPI:1033809603
Name:AKLI, IMAN B
Entity Type:Individual
Prefix:MRS
First Name:IMAN
Middle Name:B
Last Name:AKLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13850 GUILD AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7653
Mailing Address - Country:US
Mailing Address - Phone:651-208-0827
Mailing Address - Fax:651-208-0827
Practice Address - Street 1:13850 GUILD AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7653
Practice Address - Country:US
Practice Address - Phone:651-208-0827
Practice Address - Fax:651-208-0827
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNP006193809106104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker