Provider Demographics
NPI:1396558730
Name:YUSUF, ANAB M
Entity type:Individual
Prefix:
First Name:ANAB
Middle Name:M
Last Name:YUSUF
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 1:1350 ENERGY LN # 101
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-5275
Mailing Address - Country:US
Mailing Address - Phone:651-313-5162
Mailing Address - Fax:
Practice Address - Street 1:1845 UNIVERSITY AVE W UNIT W119
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3481
Practice Address - Country:US
Practice Address - Phone:651-434-4504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician