KELLY KIYOMI PONG-DER

SAN FRANCISCO, CA
NPI1295333904
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: CA  LMFT119595)
Enumeration Date2020-10-14
Last Update Date2021-01-07
Business Address
Mrs. KELLY KIYOMI PONG-DER LMFT
3638 LAWTON ST
SAN FRANCISCO, CA 94122-3008
Phone number: 415-879-8215
Mailing Address
Mrs. KELLY KIYOMI PONG-DER LMFT
PO BOX 210766
SAN FRANCISCO, CA 94121-0766
Phone number: 415-992-2318
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