Provider Demographics
NPI:1780447151
Name:UMER, BEDRIYA IBRAHIM
Entity type:Individual
Prefix:
First Name:BEDRIYA
Middle Name:IBRAHIM
Last Name:UMER
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 1:7550 FRANCE AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4788
Mailing Address - Country:US
Mailing Address - Phone:952-955-4057
Mailing Address - Fax:
Practice Address - Street 1:7550 FRANCE AVE S STE 200
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55435-4788
Practice Address - Country:US
Practice Address - Phone:952-955-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician