Provider Demographics
NPI:1407556681
Name:ABDI, IKRAM
Entity Type:Individual
Prefix:
First Name:IKRAM
Middle Name:
Last Name:ABDI
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 1:1701 AMERICAN BLVD E STE 19
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1401
Mailing Address - Country:US
Mailing Address - Phone:763-999-5938
Mailing Address - Fax:612-326-6160
Practice Address - Street 1:1701 AMERICAN BLVD E STE 19
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1401
Practice Address - Country:US
Practice Address - Phone:763-999-5938
Practice Address - Fax:612-326-6160
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health