Provider Demographics
NPI:1992590558
Name:YUSSUF, HODMAN JAMA
Entity type:Individual
Prefix:
First Name:HODMAN
Middle Name:JAMA
Last Name:YUSSUF
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MCANDREWS RD W STE 231
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4447
Mailing Address - Country:US
Mailing Address - Phone:612-237-1111
Mailing Address - Fax:763-260-9900
Practice Address - Street 1:1500 MCANDREWS RD W STE 231
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4447
Practice Address - Country:US
Practice Address - Phone:612-237-1111
Practice Address - Fax:763-260-9900
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician