Provider Demographics
NPI:1659173839
Name:MOHAMED, SUHEB SAID
Entity type:Individual
Prefix:
First Name:SUHEB
Middle Name:SAID
Last Name:MOHAMED
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 1:6595 EDENVALE BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2511
Mailing Address - Country:US
Mailing Address - Phone:612-816-8081
Mailing Address - Fax:
Practice Address - Street 1:6595 EDENVALE BLVD STE 155
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-2511
Practice Address - Country:US
Practice Address - Phone:612-816-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician