Provider Demographics
NPI:1407575707
Name:ABDINUR, AMAL M
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:M
Last Name:ABDINUR
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 1:540 FAIRVIEW AVE N STE 303
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1796
Mailing Address - Country:US
Mailing Address - Phone:347-677-3941
Mailing Address - Fax:
Practice Address - Street 1:1001 HURON RD E APT 505
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-1755
Practice Address - Country:US
Practice Address - Phone:507-202-5406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician