Provider Demographics
NPI:1932098274
Name:HUSSEIN, SUHAIB MOHAMOUD
Entity type:Individual
Prefix:
First Name:SUHAIB
Middle Name:MOHAMOUD
Last Name:HUSSEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HIGHWAY 13 E APT 123
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4814
Mailing Address - Country:US
Mailing Address - Phone:952-219-2708
Mailing Address - Fax:
Practice Address - Street 1:10650 RED CIRCLE DR STE 320
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9117
Practice Address - Country:US
Practice Address - Phone:612-987-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician