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1588410880
XAYYA THAMMAVONGSA
ALAMEDA, CA
NPI
1588410880
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-04-26
Last Update Date
2024-04-26
Business Address
XAYYA THAMMAVONGSA
1311 PARK ST # 1099
ALAMEDA, CA 94501-4507
Phone number: 888-428-3223
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Mailing Address
XAYYA THAMMAVONGSA
4221 WILSHIRE BLVD STE 300A
LOS ANGELES, CA 90010-3537
Phone number: 888-428-3223
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