Provider Demographics
NPI:1487010419
Name:VUE, PA KOU (LMFT #121352)
Entity Type:Individual
Prefix:MISS
First Name:PA KOU
Middle Name:
Last Name:VUE
Suffix:
Gender:F
Credentials:LMFT #121352
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W. SHAW AVE. #112, PMB 71
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3214
Mailing Address - Country:US
Mailing Address - Phone:559-668-1736
Mailing Address - Fax:
Practice Address - Street 1:1551 E. SHAW AVE,
Practice Address - Street 2:SUITE #116
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8007
Practice Address - Country:US
Practice Address - Phone:559-202-3390
Practice Address - Fax:559-468-0288
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
CA121352106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist