Provider Demographics
NPI:1265222186
Name:MOHAMED, ABDIRIZAK HASSAN (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:ABDIRIZAK
Middle Name:HASSAN
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 PARK AVE S
Mailing Address - Street 2:JD@BMAMN.COM
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407
Mailing Address - Country:US
Mailing Address - Phone:612-381-6080
Mailing Address - Fax:952-513-7771
Practice Address - Street 1:2750 PARK AVE S
Practice Address - Street 2:JD@BMAMN.COM
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407
Practice Address - Country:US
Practice Address - Phone:612-381-6080
Practice Address - Fax:952-513-7771
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
MNB422017382108103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst