| NPI | 1598200222 |
|---|---|
| Former Name | BUNRETH MAY SOK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61607099) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2025-03-06 |