Individual
MOUA KO MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, SWLC
Contact information
Practice address
2620 CONNERY WAY, MISSOULA, MT 59808-1325
(406) 203-9948
(406) 203-9949
Mailing address
329 CHIEF LOOKING GLASS RD, FLORENCE, MT 59833-6638
(406) 529-7997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-64332
MT
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-71084
MT
Other
Enumeration date
12/03/2021
Last updated
05/23/2024
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