KELLY THOMAS PHAN

FREMONT, CA
NPI1407609654
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: CA  46-1305562)
Enumeration Date2024-04-08
Last Update Date2024-04-08
Business Address
KELLY THOMAS PHAN
39210 STATE ST STE 220
FREMONT, CA 94538-1456
Phone number: 510-894-4135
Mailing Address
KELLY THOMAS PHAN
255 UNION AVE APT D1073
CAMPBELL, CA 95008-3541
Phone number:
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