Individual
MOSICROWN THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
2165 WOODLANE DR STE 100, WOODBURY, MN 55125-3055
(651) 283-3794
(651) 738-1881
Mailing address
2165 WOODLANE DR STE 100, WOODBURY, MN 55125-3055
(651) 283-3794
(651) 738-1881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC04576
MN
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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