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1518712785
JUSTIN JITHAKONE SOUNGPANYA
CONCORD, CA
NPI
1518712785
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-04-22
Last Update Date
2024-04-22
Business Address
JUSTIN JITHAKONE SOUNGPANYA
1855 2ND ST STE B
CONCORD, CA 94519-2623
Phone number: 855-223-7123
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Mailing Address
JUSTIN JITHAKONE SOUNGPANYA
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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