| NPI | 1679892863 |
|---|---|
| Former Name | CHANTELLE MARIE PHONESAVANH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN248651) |
| Additional Taxonomies | 374J00000X Doula |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2026-04-27 |