Individual
TITANIA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 ROSS AVE, SAINT PAUL, MN 55106-3941
(651) 468-7203
Mailing address
1160 ROSS AVE, SAINT PAUL, MN 55106-3941
(651) 468-7203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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