Provider Demographics
NPI:1780392324
Name:SHARIFF, ASMA
Entity type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:SHARIFF
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 1:15583 FINCH AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5822
Mailing Address - Country:US
Mailing Address - Phone:651-395-8794
Mailing Address - Fax:
Practice Address - Street 1:6260 HIGHWAY 65 NE # 303
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55432-5150
Practice Address - Country:US
Practice Address - Phone:614-218-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician