Individual
AMANDA PANG FOUA MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1501 XERXES AVE N, MINNEAPOLIS, MN 55411-2851
(612) 977-3236
(612) 521-3893
Mailing address
1501 XERXES AVE N, MINNEAPOLIS, MN 55411-2851
(763) 521-3477
(763) 521-3893
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4152565
MN
Other
Enumeration date
06/27/2018
Last updated
07/10/2018
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