PHOUSAVANH SOUTHISOMBATH

FRESNO, CA
NPI1295497360
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy106S00000X Behavior Technician
Enumeration Date2021-10-06
Last Update Date2021-10-06
Business Address
PHOUSAVANH SOUTHISOMBATH
1401 FULTON ST STE 200
FRESNO, CA 93721-1646
Phone number: 559-348-9225
Mailing Address
PHOUSAVANH SOUTHISOMBATH
1401 FULTON ST STE 200
FRESNO, CA 93721-1646
Phone number: 559-348-9225
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