Provider Demographics
NPI:1255138566
Name:AHMED, SHAFI ABDULLAHI
Entity type:Individual
Prefix:
First Name:SHAFI
Middle Name:ABDULLAHI
Last Name:AHMED
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 1:4614 ISLAND PARK BAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5754
Mailing Address - Country:US
Mailing Address - Phone:612-483-2640
Mailing Address - Fax:612-886-7277
Practice Address - Street 1:4614 ISLAND PARK BAY
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-5754
Practice Address - Country:US
Practice Address - Phone:612-483-2640
Practice Address - Fax:612-886-7277
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician