Provider Demographics
NPI:1639948920
Name:YUSUF, AHLAM BADRI
Entity Type:Individual
Prefix:
First Name:AHLAM
Middle Name:BADRI
Last Name:YUSUF
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 1:7124 41ST ST N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-2600
Mailing Address - Country:US
Mailing Address - Phone:651-235-9936
Mailing Address - Fax:
Practice Address - Street 1:7124 41ST ST N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-2600
Practice Address - Country:US
Practice Address - Phone:651-235-9936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician