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1043791791
SANDY SANAVONGXAY
CRYSTAL LAKE, IL
NPI
1043791791
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: IL S51578095629)
Enumeration Date
2018-08-21
Last Update Date
2018-08-21
Business Address
SANDY SANAVONGXAY
780 MCARDLE DR STE A
CRYSTAL LAKE, IL 60014-8155
Phone number: 779-220-6262
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Mailing Address
SANDY SANAVONGXAY
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number: 818-345-2345
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