Provider Demographics
NPI:1376212670
Name:ALDAWOODI, MOHAMMED ABDUL KAREEM
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ABDUL KAREEM
Last Name:ALDAWOODI
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 1:12286 UTICA ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5640
Mailing Address - Country:US
Mailing Address - Phone:720-352-7458
Mailing Address - Fax:720-729-8333
Practice Address - Street 1:12286 UTICA ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-5640
Practice Address - Country:US
Practice Address - Phone:720-352-7458
Practice Address - Fax:720-729-8333
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician