Individual
BAO VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 ROUND LAKE BLVD NW, ANOKA, MN 55303-3315
(952) 247-3581
Mailing address
3731 RUM RIVER DR, ANOKA, MN 55303-1106
(763) 762-0089
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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