Provider Demographics
NPI:1265325278
Name:DOUMBOUYA, MAHAWA JAMILA (MHP)
Entity type:Individual
Prefix:
First Name:MAHAWA
Middle Name:JAMILA
Last Name:DOUMBOUYA
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:MAWATA
Other - Middle Name:
Other - Last Name:SESAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHP
Mailing Address - Street 1:5769 EGAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4917
Mailing Address - Country:US
Mailing Address - Phone:612-275-2249
Mailing Address - Fax:
Practice Address - Street 1:5769 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4917
Practice Address - Country:US
Practice Address - Phone:952-200-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst