Provider Demographics
NPI:1811731193
Name:DAHIR, NIMO MOHAMED
Entity type:Individual
Prefix:MISS
First Name:NIMO
Middle Name:MOHAMED
Last Name:DAHIR
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 1:8520 CARDIFF LN
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7660
Mailing Address - Country:US
Mailing Address - Phone:619-558-6340
Mailing Address - Fax:
Practice Address - Street 1:8520 CARDIFF LN
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7660
Practice Address - Country:US
Practice Address - Phone:619-558-6340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician