Provider Demographics
NPI:1063039873
Name:ABDILLAHI, HODAN ABDI
Entity Type:Individual
Prefix:
First Name:HODAN
Middle Name:ABDI
Last Name:ABDILLAHI
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 1:5275 EDINA INDUSTRIAL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2915
Mailing Address - Country:US
Mailing Address - Phone:952-288-9115
Mailing Address - Fax:952-960-0137
Practice Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2915
Practice Address - Country:US
Practice Address - Phone:952-288-9115
Practice Address - Fax:952-960-0137
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician