Individual
SOUA LY MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 NE GREENWAY DR, GRESHAM, OR 97030-1702
(562) 644-4413
(562) 490-7601
Mailing address
330 NE GREENWAY DR, GRESHAM, OR 97030-1702
(562) 644-4413
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC50724
CA
Other
Enumeration date
03/07/2007
Last updated
12/17/2020
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