Provider Demographics
NPI:1336027176
Name:ABDI, MARYAN SHUKRI
Entity type:Individual
Prefix:
First Name:MARYAN
Middle Name:SHUKRI
Last Name:ABDI
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 1:1701 AMERICAN BLVD E STE 19
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1404
Mailing Address - Country:US
Mailing Address - Phone:207-408-6684
Mailing Address - Fax:
Practice Address - Street 1:1701 AMERICAN BLVD E STE 19
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1404
Practice Address - Country:US
Practice Address - Phone:207-408-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health