Individual
CHOUA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 BALLPARK LN APT 5101, LAWRENCEVILLE, GA 30043-2293
(916) 764-2748
Mailing address
1110 BALLPARK LN APT 5101, LAWRENCEVILLE, GA 30043-2293
(916) 764-2748
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
03/10/2022
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