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1063982049
BRUNO SIVONGXAY
FRESNO, CA
NPI
1063982049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-12-03
Last Update Date
2018-12-03
Business Address
BRUNO SIVONGXAY
2772 SOUTH MARTIN L KING JR BLVD
FRESNO, CA 93706
Phone number: 559-265-4800
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Mailing Address
BRUNO SIVONGXAY
2772 SOUTH MARTIN L KING JR. BLVD
FRESNO, CA 93706
Phone number:
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