| NPI | 1083133375 |
|---|---|
| Other Name | SITTHIVANH MANIVONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 84929) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1801003) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2021-01-23 |