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1447474382
PHANNONG JACKSON
STOCKTON, CA
NPI
1447474382
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA IMF41435)
Enumeration Date
2007-04-12
Last Update Date
2007-07-08
Business Address
-- PHANNONG JACKSON MFTI
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8700
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Mailing Address
-- PHANNONG JACKSON MFTI
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8700
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