MICHELLE LANE PHOMMACHIT

SAN LEANDRO, CA
NPI1326639956
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  11468)
Enumeration Date2021-01-27
Last Update Date2021-01-27
Business Address
MICHELLE LANE PHOMMACHIT
2035 FAIRMONT DR # SR
SAN LEANDRO, CA 94578-1088
Phone number: 866-866-7496
Mailing Address
MICHELLE LANE PHOMMACHIT
39663 LESLIE ST APT 424
FREMONT, CA 94538-2243
Phone number: 408-707-7122
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