Individual
CHEENUE THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2812 FAIRVIEW AVE N, ROSEVILLE, MN 55113-1308
(612) 345-7306
Mailing address
2173 6TH ST E, SAINT PAUL, MN 55119-3918
(651) 353-4287
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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