Provider Demographics
NPI:1447953880
Name:MOHAMUD, SADIYA
Entity type:Individual
Prefix:
First Name:SADIYA
Middle Name:
Last Name:MOHAMUD
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 1:1225 20TH ST SE APT 303
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6501
Mailing Address - Country:US
Mailing Address - Phone:507-271-7557
Mailing Address - Fax:
Practice Address - Street 1:1225 20TH ST SE APT 303
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6501
Practice Address - Country:US
Practice Address - Phone:507-271-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician