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1760015861
CHINALY SOURIVONG
SACRAMENTO, CA
NPI
1760015861
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-02-17
Last Update Date
2020-02-17
Business Address
CHINALY SOURIVONG
800 HOWE AVE STE 140
SACRAMENTO, CA 95825-3965
Phone number: 916-350-1737
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Mailing Address
CHINALY SOURIVONG
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 949-833-2237
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