Provider Demographics
NPI:1164145603
Name:ALI, SALMA BASHIR I
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:BASHIR
Last Name:ALI
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 1:919 12TH AVE SE APT 107
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2388
Mailing Address - Country:US
Mailing Address - Phone:612-558-7235
Mailing Address - Fax:
Practice Address - Street 1:919 12TH AVE SE APT 107
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2388
Practice Address - Country:US
Practice Address - Phone:612-558-7235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty