Provider Demographics
NPI:1508613837
Name:JAMA, RUKIA ABDILAHI
Entity type:Individual
Prefix:
First Name:RUKIA
Middle Name:ABDILAHI
Last Name:JAMA
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 1:1928 PORTLAND AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-6203
Mailing Address - Country:US
Mailing Address - Phone:920-371-9780
Mailing Address - Fax:
Practice Address - Street 1:2625 E FRANKLIN AVE STE LL4
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1195
Practice Address - Country:US
Practice Address - Phone:763-213-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health