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Individual

MAI MOUA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11606 WAYZATA BLVD, MINNETONKA, MN 55305-2009
(952) 554-0319
Mailing address
3742 GERSHWIN AVE N, OAKDALE, MN 55128-3006

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
105035
MN

Other

Enumeration date
06/24/2016
Last updated
06/24/2016
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