Individual
BLIA VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 N GRAND AVE, WAUKESHA, WI 53186-4984
(262) 290-3651
Mailing address
403 N GRAND AVE, WAUKESHA, WI 53186-4984
(414) 290-3651
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4371-226
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/11/2016
Last updated
07/10/2020
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