Provider Demographics
NPI:1376196576
Name:AHMED, ASHA A
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:A
Last Name:AHMED
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 1:3355 HIAWATHA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2441
Mailing Address - Country:US
Mailing Address - Phone:612-886-2624
Mailing Address - Fax:612-886-2618
Practice Address - Street 1:3355 HIAWATHA AVE STE 100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2441
Practice Address - Country:US
Practice Address - Phone:612-886-2624
Practice Address - Fax:612-886-2618
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician