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1891902342
KHRAYTHONG SOUPHOLPHAKDY
SANTA ROSA, CA
NPI
1891902342
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-05-16
Last Update Date
2014-08-25
Business Address
-- KHRAYTHONG SOUPHOLPHAKDY
1221 FARMERS LN SUITE B
SANTA ROSA, CA 95405-6712
Phone number: 707-565-6953
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Mailing Address
-- KHRAYTHONG SOUPHOLPHAKDY
1221 FARMERS LN
SANTA ROSA, CA 95405-6712
Phone number: 707-565-6953
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