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Individual

KHONG KALEB MUA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415-1533
(612) 596-1223
Mailing address
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415-1533
(612) 596-1223

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305829
MN
106H00000X
Marriage & Family Therapist
Primary
2458
MN

Other

Enumeration date
05/14/2009
Last updated
01/27/2025
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