Provider Demographics
NPI:1053139691
Name:GUREYE, SALMA
Entity type:Individual
Prefix:
First Name:SALMA
Middle Name:
Last Name:GUREYE
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 1:20457 GINGER CT
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-5099
Mailing Address - Country:US
Mailing Address - Phone:612-242-4295
Mailing Address - Fax:
Practice Address - Street 1:12180 COUNTY ROAD 11
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-3018
Practice Address - Country:US
Practice Address - Phone:612-242-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician