Provider Demographics
NPI:1861296931
Name:MOHAMED, HABIBA MUHAMUD AHMED
Entity type:Individual
Prefix:
First Name:HABIBA
Middle Name:MUHAMUD AHMED
Last Name:MOHAMED
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 1:8100 31ST AVE S APT A630
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-7404
Mailing Address - Country:US
Mailing Address - Phone:612-297-0404
Mailing Address - Fax:
Practice Address - Street 1:7101 YORK AVE S STE 335
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4428
Practice Address - Country:US
Practice Address - Phone:612-481-0766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician