VIENGKEO CHANTHALOTH- PHASOUK

ROCKFORD, IL
NPI1366920811
Professional NameVIENGKEO PHASOUK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.022418)
Additional Taxonomies101Y00000X Counselor
Enumeration Date2018-08-06
Last Update Date2020-08-13
Business Address
VIENGKEO CHANTHALOTH- PHASOUK LCSW
2704 N MAIN ST
ROCKFORD, IL 61103-3112
Phone number: 815-391-1000
Mailing Address
VIENGKEO CHANTHALOTH- PHASOUK LCSW
1021 N MULFORD RD
ROCKFORD, IL 61107-3877
Phone number: