Provider Demographics
NPI:1457105983
Name:VANG, KAUNHOU
Entity Type:Individual
Prefix:
First Name:KAUNHOU
Middle Name:
Last Name:VANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 GEORGE ST # 1068
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-2939
Mailing Address - Country:US
Mailing Address - Phone:920-265-5976
Mailing Address - Fax:
Practice Address - Street 1:905 GEORGE ST # 1068
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-2939
Practice Address - Country:US
Practice Address - Phone:920-265-5976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker