Provider Demographics
NPI:1316735681
Name:MOHAMED, UMALKHAIR A
Entity type:Individual
Prefix:MISS
First Name:UMALKHAIR
Middle Name:A
Last Name:MOHAMED
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 NICOLS RD # 104
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3337
Mailing Address - Country:US
Mailing Address - Phone:651-900-2210
Mailing Address - Fax:651-900-2210
Practice Address - Street 1:4635 NICOLS RD # 104
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3337
Practice Address - Country:US
Practice Address - Phone:651-900-2210
Practice Address - Fax:651-900-2210
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician