KHETLHAMANY ERIKA BANNAVONG

WEST LIBERTY, IA
NPI1245945567
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: PA  SL018239)
Additional Taxonomies235Z00000X Speech-Language Pathologist,
(Licence: IA  114797)
Enumeration Date2023-01-20
Last Update Date2025-02-17
Business Address
KHETLHAMANY ERIKA BANNAVONG M.A., CCC-SLP
1253 ELDER RIDGE RD
WEST LIBERTY, IA 52776-9161
Phone number: 195-417-7853
Mailing Address
KHETLHAMANY ERIKA BANNAVONG M.A., CCC-SLP
1253 ELDER RIDGE RD
WEST LIBERTY, IA 52776-9161
Phone number: 319-541-7785