| NPI | 1245284462 |
|---|---|
| Former Name | VONGVINATH SISAUYHOAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2833-057) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 016412-1) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301013376) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2010-06-02 |