Provider Demographics
NPI:1033821160
Name:ABDI, AMRAN AHMEDRABIR
Entity Type:Individual
Prefix:
First Name:AMRAN
Middle Name:AHMEDRABIR
Last Name:ABDI
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 1:1518 E LAKE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1849
Mailing Address - Country:US
Mailing Address - Phone:612-249-7007
Mailing Address - Fax:
Practice Address - Street 1:1518 E LAKE ST STE 201
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1849
Practice Address - Country:US
Practice Address - Phone:612-249-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician