Provider Demographics
NPI:1063215804
Name:MOHAMED, YUSUF
Entity type:Individual
Prefix:
First Name:YUSUF
Middle Name:
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 1:1350 ENERGY LN # 101
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-5275
Mailing Address - Country:US
Mailing Address - Phone:651-313-5162
Mailing Address - Fax:651-493-9439
Practice Address - Street 1:1350 ENERGY LN # 101
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-5275
Practice Address - Country:US
Practice Address - Phone:651-313-5162
Practice Address - Fax:651-493-9439
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician