Individual
SOUA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
620 MINNEAHAHA AVENUE APT #1, ST. PAUL, MN 55106
(651) 216-2549
Mailing address
620 MINNEAHAHA AVENUE APT #1, ST. PAUL, MN 55106
(651) 216-2549
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
MN
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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