Individual
ADA MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7010 HIGHWAY 7, ST LOUIS PARK, MN 55426-4223
(952) 814-0207
Mailing address
279 DEMONT AVE E, LITTLE CANADA, MN 55117-1612
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R878-180-025-423
MN
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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