KEVIN PANYANOUVONG

MODESTO, CA
NPI1033245857
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  25999)
Additional Taxonomies101YP2500X Counselor, Professional
Enumeration Date2007-02-26
Last Update Date2021-12-20
Business Address
Mr. KEVIN PANYANOUVONG LCSW
800 SCENIC DR
MODESTO, CA 95350-6131
Phone number: 209-525-6225
Mailing Address
Mr. KEVIN PANYANOUVONG LCSW
800 SCENIC DR
MODESTO, CA 95350-6131
Phone number: 209-525-6225