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1417223504
SOVANNARY BOU
STOCKTON, CA
NPI
1417223504
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA PT 35993)
Enumeration Date
2012-03-22
Last Update Date
2012-03-22
Business Address
SOVANNARY BOU
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8750
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Mailing Address
SOVANNARY BOU
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8750
Copy
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