Individual
MAI NTSHIAB THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
6776 LAKE DR STE 170, LINO LAKES, MN 55014-1201
(763) 291-5505
Mailing address
3189 MIDLAND AVE, WHITE BEAR LAKE, MN 55110-5319
(651) 350-9015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4145
MN
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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