Provider Demographics
NPI:1740093301
Name:AHMED, MUNA M
Entity type:Individual
Prefix:
First Name:MUNA
Middle Name:M
Last Name:AHMED
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 1:760 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1952
Mailing Address - Country:US
Mailing Address - Phone:612-442-3275
Mailing Address - Fax:
Practice Address - Street 1:2109 NICOLLET AVE STE 105
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3279
Practice Address - Country:US
Practice Address - Phone:612-584-3068
Practice Address - Fax:612-584-3041
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician