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1750058343
SOMSAY CHANTHAVONGSOR
SANTA MARIA, CA
NPI
1750058343
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2021-08-23
Last Update Date
2021-09-28
Business Address
SOMSAY CHANTHAVONGSOR
115 E FESLER ST
SANTA MARIA, CA 93454-4404
Phone number: 805-922-6597
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Mailing Address
SOMSAY CHANTHAVONGSOR
7246 REMMET AVE
CANOGA PARK, CA 91303-1531
Phone number: 818-206-0360
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