Provider Demographics
NPI:1275342107
Name:NOOR, FATUMO A
Entity type:Individual
Prefix:
First Name:FATUMO
Middle Name:A
Last Name:NOOR
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 1:9358 ENSIGN AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1472
Mailing Address - Country:US
Mailing Address - Phone:612-867-2987
Mailing Address - Fax:
Practice Address - Street 1:9358 ENSIGN AVE S STE C
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1472
Practice Address - Country:US
Practice Address - Phone:612-213-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician