Provider Demographics
NPI:1053173740
Name:DAHIR, RAHMA MOHAMED
Entity type:Individual
Prefix:
First Name:RAHMA
Middle Name:MOHAMED
Last Name:DAHIR
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 1:2042 WOODDALE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4421
Mailing Address - Country:US
Mailing Address - Phone:614-615-5544
Mailing Address - Fax:
Practice Address - Street 1:2042 WOODDALE DR STE 250
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4421
Practice Address - Country:US
Practice Address - Phone:614-615-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty