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1790241917
CHANSOMOLLY KIM
FULLERTON, CA
NPI
1790241917
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-02-12
Last Update Date
2019-02-12
Business Address
CHANSOMOLLY KIM BA
713 W COMMONWEALTH AVE STE C
FULLERTON, CA 92832-1612
Phone number: 714-879-4274
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Mailing Address
CHANSOMOLLY KIM BA
5821 CALIFORNIA AVE
LONG BEACH, CA 90805-4120
Phone number: 562-396-6211
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