| Soua Ly Moua, | |
| 
					330 Ne Greenway Dr, Gresham, OR 97030-1702  | |
| (562) 644-4413 | |
| (562) 490-7601 | 
| Full Name | Soua Ly Moua | 
|---|---|
| Gender | Female | 
| Speciality | Marriage & Family Therapist | 
| Location | 330 Ne Greenway Dr, Gresham, Oregon | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1053442707 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC50724 (California) | Primary | 
| Entity Name | Izzo Marriage & Family Therapy Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1518557552 PECOS PAC ID: 5092249490 Enrollment ID: O20241107002046  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Soua Ly Moua, 330 Ne Greenway Dr, Gresham, OR 97030-1702 Ph: (562) 644-4413  | Soua Ly Moua, 330 Ne Greenway Dr, Gresham, OR 97030-1702 Ph: (562) 644-4413  | 
Ms. Sabrina Joye Hindman, M.ED, MFTI Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 6370 Se 26th St, Gresham, OR 97080 Phone: 503-703-0657 Fax: 503-907-6508  | |
Mrs. Angela M Caiazza, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 123 E Powell Blvd, Suite #303, Gresham, OR 97030 Phone: 503-516-8266  | |
Ms. Kathleen Suzanne Leavitt, M.ED. Couples Therapy Medicare: Medicare Enrolled Practice Location: 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030 Phone: 503-666-8832  | |
Aubriel Rose Feinstein, MA Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 649 Ne Hood Ave, Gresham, OR 97030 Phone: 971-404-4668  | |
Ms. Bethanie Schmoeller, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 21016 Se Start St Unit 64, Gresham, OR 97030 Phone: 818-429-1602  | |
Mr. Curtis Dean Hall, M.S., LCMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 1700 Nw Civic Dr Ste 310, Gresham, OR 97030 Phone: 503-666-8832  |