KHETLHAMANY ERIKA BANNAVONG

CORALVILLE, IA
NPI1245945567
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IA  114797)
Enumeration Date2023-01-20
Last Update Date2023-01-20
Business Address
KHETLHAMANY ERIKA BANNAVONG M.A., CF-SLP
2332 LIBERTY DR
CORALVILLE, IA 52241-2771
Phone number: 319-545-7390
Mailing Address
KHETLHAMANY ERIKA BANNAVONG M.A., CF-SLP
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE, OR 97222-4628
Phone number: