Provider Demographics
NPI:1811889983
Name:HIRMOGE, IQRA
Entity type:Individual
Prefix:
First Name:IQRA
Middle Name:
Last Name:HIRMOGE
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 1:1446 ALBEMARLE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-3802
Mailing Address - Country:US
Mailing Address - Phone:651-443-9689
Mailing Address - Fax:
Practice Address - Street 1:2575 FAIRVIEW AVE N STE 250
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-2607
Practice Address - Country:US
Practice Address - Phone:763-291-7652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician