Provider Demographics
NPI:1275395675
Name:FARAH, RAHMO ABDIRAHMAN
Entity Type:Individual
Prefix:
First Name:RAHMO
Middle Name:ABDIRAHMAN
Last Name:FARAH
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 1:3500 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2151
Mailing Address - Country:US
Mailing Address - Phone:612-772-8031
Mailing Address - Fax:
Practice Address - Street 1:3500 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2151
Practice Address - Country:US
Practice Address - Phone:612-772-8031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician