Provider Demographics
NPI:1487528816
Name:ABDISALAM, ABDULLAHI SAID
Entity type:Individual
Prefix:
First Name:ABDULLAHI
Middle Name:SAID
Last Name:ABDISALAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N 30TH ST APT 1062
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6133
Mailing Address - Country:US
Mailing Address - Phone:602-693-5294
Mailing Address - Fax:
Practice Address - Street 1:802 N 30TH ST APT 1062
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6133
Practice Address - Country:US
Practice Address - Phone:602-693-5294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician