Por Moua
Behavior Technician in Merced, CA. Individual provider (NPI-1).
NPI number1124658570
StatusActive
Last updated in NPPESJan 23, 2020
Details
- NPI
- 1124658570
- Entity type
- Individual (NPI-1)
- Name
- Por Moua
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 23, 2020
- Certification date
- Jan 23, 2020
- Last updated
- Jan 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
597 E San Xavier CtMerced, CA 95341-6991
Phone 209-233-5475
Mailing address
3425 Coffee Rd Ste C2Modesto, CA 95355-1582
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