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1114335072
LAURY THAMMAVONG
SAN FRANCISCO, CA
NPI
1114335072
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1-T1407081924)
Enumeration Date
2014-07-23
Last Update Date
2014-07-23
Business Address
-- LAURY THAMMAVONG
1735 MISSION ST
SAN FRANCISCO, CA 94103-2417
Phone number: 415-226-1775
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Mailing Address
-- LAURY THAMMAVONG
1735 MISSION ST
SAN FRANCISCO, CA 94103-2417
Phone number: 415-226-1775
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