Organization
MOUA AUTISM SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIYAPORN MOUA BCBA (EXECUTIVE DIRECTOR)
(608) 422-3575
Entity
Organization
Contact information
Practice address
530 PLAZA DR APT 104, MADISON, WI 53719-3853
(608) 422-3575
Mailing address
530 PLAZA DR APT 104, MADISON, WI 53719-3853
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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