Provider Demographics
NPI:1992429138
Name:HERSI, YASMIN MOHAMED
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:MOHAMED
Last Name:HERSI
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 1:5803 XERXES AVE N APT 101
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2844
Mailing Address - Country:US
Mailing Address - Phone:619-918-5537
Mailing Address - Fax:
Practice Address - Street 1:5803 XERXES AVE N APT 101
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2844
Practice Address - Country:US
Practice Address - Phone:619-918-5537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty