Provider Demographics
NPI:1588436059
Name:ABDIKADIR, MARYAN ABDINUR
Entity type:Individual
Prefix:
First Name:MARYAN
Middle Name:ABDINUR
Last Name:ABDIKADIR
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 1:7990 OLD CEDAR AVE S APT 119
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1209
Mailing Address - Country:US
Mailing Address - Phone:612-263-4410
Mailing Address - Fax:
Practice Address - Street 1:2530 E 34TH ST APT 205
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-4520
Practice Address - Country:US
Practice Address - Phone:612-615-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health