Provider Demographics
NPI:1083452965
Name:ABDULAHI, SUHUR
Entity type:Individual
Prefix:
First Name:SUHUR
Middle Name:
Last Name:ABDULAHI
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 1:1935 COUNTY ROAD B2 W STE 405
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2797
Mailing Address - Country:US
Mailing Address - Phone:612-256-9903
Mailing Address - Fax:612-444-8821
Practice Address - Street 1:1935 COUNTY ROAD B2 W STE 405
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-2797
Practice Address - Country:US
Practice Address - Phone:612-256-9903
Practice Address - Fax:612-444-8821
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician