Provider Demographics
NPI:1760211817
Name:ABDI, AMINA (CDCA)
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:ABDI
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 LASKO CIR W # 331
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8790
Mailing Address - Country:US
Mailing Address - Phone:614-964-8561
Mailing Address - Fax:
Practice Address - Street 1:329 LASKO CIR W # 331
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8790
Practice Address - Country:US
Practice Address - Phone:614-964-8561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.188888101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)