Provider Demographics
NPI:1275389322
Name:MUHUMED, HAYAT
Entity type:Individual
Prefix:
First Name:HAYAT
Middle Name:
Last Name:MUHUMED
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 1:2626 18TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1210
Mailing Address - Country:US
Mailing Address - Phone:651-802-3872
Mailing Address - Fax:
Practice Address - Street 1:3055 OLD HIGHWAY 8 STE 190
Practice Address - Street 2:
Practice Address - City:ST ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55418-2595
Practice Address - Country:US
Practice Address - Phone:612-345-7659
Practice Address - Fax:612-605-6300
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician