KELLY T PHAM

MODESTO, CA
NPI1114231669
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: CA  PSY29070)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2010-07-27
Last Update Date2023-01-22
Business Address
KELLY T PHAM
1015 12TH ST STE 2
MODESTO, CA 95354-0838
Phone number: 209-496-2327
Mailing Address
KELLY T PHAM
1015 12TH ST STE 2
MODESTO, CA 95354-0838
Phone number: 209-496-2327