Provider Demographics
NPI:1215771183
Name:ABDI, SUHAYB
Entity type:Individual
Prefix:
First Name:SUHAYB
Middle Name:
Last Name:ABDI
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 1:4911 77TH ST W APT 501
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4840
Mailing Address - Country:US
Mailing Address - Phone:763-600-4133
Mailing Address - Fax:866-635-1990
Practice Address - Street 1:4911 77TH ST W APT 501
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55435-4840
Practice Address - Country:US
Practice Address - Phone:763-600-4133
Practice Address - Fax:866-635-1990
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician