Individual
CHOUA LINDA VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 N PORT WASHINGTON RD, GLENDALE, WI 53217-3919
(414) 351-8850
Mailing address
4022 N 93RD ST, WAUWATOSA, WI 53222-1505
(414) 394-7303
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5642-26
WI
225XP0200X
Pediatric Occupational Therapist
5642-26
WI
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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