Provider Demographics
NPI:1821791013
Name:AHMED, HADITH YUSUF
Entity Type:Individual
Prefix:
First Name:HADITH
Middle Name:YUSUF
Last Name:AHMED
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 1:15502 MICHELE LN
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2547
Mailing Address - Country:US
Mailing Address - Phone:651-353-9569
Mailing Address - Fax:
Practice Address - Street 1:8700 W 36TH ST STE 221
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3906
Practice Address - Country:US
Practice Address - Phone:763-346-0522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician