Provider Demographics
NPI:1245026533
Name:ABDI, FATUMA
Entity type:Individual
Prefix:
First Name:FATUMA
Middle Name:
Last Name:ABDI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 1ST ST N STE 303
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1927
Mailing Address - Country:US
Mailing Address - Phone:612-597-8712
Mailing Address - Fax:323-784-0210
Practice Address - Street 1:3400 1ST ST N STE 303
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1927
Practice Address - Country:US
Practice Address - Phone:612-597-8712
Practice Address - Fax:323-784-0210
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician