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1477108249
ALLYSSA B PHONGLOM
ELK GROVE, CA
NPI
1477108249
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-08-07
Last Update Date
2019-08-07
Business Address
ALLYSSA B PHONGLOM
9355 E STOCKTON BLVD STE 100
ELK GROVE, CA 95624-9476
Phone number: 209-572-2589
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Mailing Address
ALLYSSA B PHONGLOM
PO BOX 5157
MODESTO, CA 95352-5157
Phone number:
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