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1942915921
LAURA PHALIVUTH
STOCKTON, CA
NPI
1942915921
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-01-13
Last Update Date
2023-01-13
Business Address
LAURA PHALIVUTH
306 E MAIN ST STE 307
STOCKTON, CA 95202-2908
Phone number: 209-478-4554
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Mailing Address
LAURA PHALIVUTH
306 E MAIN ST STE 307
STOCKTON, CA 95202-2908
Phone number: 209-478-4554
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