Individual
VANG MOUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 S BLACK RIVER ST, SPARTA, WI 54656-2043
(608) 501-1189
Mailing address
300 LIBERTY ST APT 2104, LA CROSSE, WI 54603-3206
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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