Provider Demographics
NPI:1407548134
Name:ABDILLAHI, SHUKRI ABDIHAKIM
Entity Type:Individual
Prefix:
First Name:SHUKRI
Middle Name:ABDIHAKIM
Last Name:ABDILLAHI
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 1:5624 LINCOLN DR STE 295
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-1606
Mailing Address - Country:US
Mailing Address - Phone:952-395-3322
Mailing Address - Fax:
Practice Address - Street 1:5624 LINCOLN DR STE 295
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-1606
Practice Address - Country:US
Practice Address - Phone:952-395-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician