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General NPI Number Information
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NPI Number | 1114864824
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Entity Type | Individual
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Provider Name | SUSAN KASHIA VANG
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Gender | Female
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 35 FINN ST S
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City | SAINT PAUL
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State | MN
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Zip | 55105-1012
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Country | US
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Telephone | 612-962-6750
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 EUSTIS ST APT 230
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City | LAUDERDALE
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State | MN
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Zip | 55108-1279
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Country | US
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Telephone | 920-450-8297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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