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1073155206
FIDELA BOUATHONG
SACRAMENTO, CA
NPI
1073155206
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
Enumeration Date
2019-10-09
Last Update Date
2019-10-09
Business Address
FIDELA BOUATHONG
500 JESSIE AVE
SACRAMENTO, CA 95838-2609
Phone number: 916-922-7177
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Mailing Address
FIDELA BOUATHONG
623 14TH ST
SACRAMENTO, CA 95814
Phone number:
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