Provider Demographics
NPI:1063021459
Name:ISMAIL, AAMINA MOHAMUD I
Entity Type:Individual
Prefix:
First Name:AAMINA
Middle Name:MOHAMUD
Last Name:ISMAIL
Suffix:I
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 1:373 WINTHROP ST S APT 157
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5355
Mailing Address - Country:US
Mailing Address - Phone:651-925-9281
Mailing Address - Fax:
Practice Address - Street 1:373 WINTHROP ST S APT 157
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-5355
Practice Address - Country:US
Practice Address - Phone:651-925-9281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician