Provider Demographics
NPI:1427750504
Name:RAN, AYAN SULEIMAN
Entity type:Individual
Prefix:
First Name:AYAN
Middle Name:SULEIMAN
Last Name:RAN
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 1:1530 S 6TH ST APT C1404
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1135
Mailing Address - Country:US
Mailing Address - Phone:763-332-9400
Mailing Address - Fax:
Practice Address - Street 1:1821 UNIVERSITY AVE W # 223
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2801
Practice Address - Country:US
Practice Address - Phone:612-968-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician