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1417378308
TERESA THAMMAVONG
SPRING VALLEY, CA
NPI
1417378308
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-12-19
Last Update Date
2013-12-19
Business Address
-- TERESA THAMMAVONG
2315 BAR BIT RD
SPRING VALLEY, CA 91978-1901
Phone number: 619-337-3830
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Mailing Address
-- TERESA THAMMAVONG
2315 BAR BIT RD
SPRING VALLEY, CA 91978-1901
Phone number: 619-337-3830
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