Individual
SANDY MOUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58945 BUSINESS CENTER DR, SUITE D, YUCCA VALLEY, CA 92284-7307
(760) 228-9657
Mailing address
37586 COLLEGE DR, UNIT 101, PALM DESERT, CA 92211-2926
(951) 233-5985
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36344
CA
Other
Enumeration date
02/15/2013
Last updated
02/20/2013
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