Provider Demographics
NPI:1255215935
Name:GELJIRE, FAHIMO
Entity type:Individual
Prefix:
First Name:FAHIMO
Middle Name:
Last Name:GELJIRE
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 1:6400 RICHFIELD PKWY APT 333
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-6415
Mailing Address - Country:US
Mailing Address - Phone:612-212-9918
Mailing Address - Fax:952-513-2053
Practice Address - Street 1:6400 RICHFIELD PKWY APT 333
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-6415
Practice Address - Country:US
Practice Address - Phone:612-212-9918
Practice Address - Fax:952-513-2053
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician