Provider Demographics
NPI:1275213340
Name:ABDULWAHID, ABDULRAHMAN ASKARI
Entity Type:Individual
Prefix:
First Name:ABDULRAHMAN
Middle Name:ASKARI
Last Name:ABDULWAHID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 JAMES AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2317
Mailing Address - Country:US
Mailing Address - Phone:612-226-0907
Mailing Address - Fax:
Practice Address - Street 1:9340 JAMES AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-2317
Practice Address - Country:US
Practice Address - Phone:612-226-0907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health