Provider Demographics
NPI:1194325381
Name:YASIN, SCHARMARKE ABDULLAHI
Entity type:Individual
Prefix:
First Name:SCHARMARKE
Middle Name:ABDULLAHI
Last Name:YASIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE 219
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2892
Mailing Address - Country:US
Mailing Address - Phone:612-704-6050
Mailing Address - Fax:651-333-5599
Practice Address - Street 1:1821 UNIVERSITY AVE W STE 219
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2892
Practice Address - Country:US
Practice Address - Phone:612-704-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN123456789OtherN/A