Provider Demographics
NPI:1861293433
Name:ABDI, SUHUR
Entity type:Individual
Prefix:
First Name:SUHUR
Middle Name:
Last Name:ABDI
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 1:641 89TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-2302
Mailing Address - Country:US
Mailing Address - Phone:612-464-4132
Mailing Address - Fax:
Practice Address - Street 1:641 89TH AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-2302
Practice Address - Country:US
Practice Address - Phone:612-464-4132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician