SAMOUT KETTAVONG

DALLAS, TX
NPI1962982017
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: TX  114529)
Enumeration Date2018-08-17
Last Update Date2022-05-24
Business Address
SAMOUT KETTAVONG CCC-SLP
1881 SYLVAN AVE # 150
DALLAS, TX 75208-2083
Phone number: 214-333-7041
Mailing Address
SAMOUT KETTAVONG CCC-SLP
1881 SYLVAN AVE # 150
DALLAS, TX 75208-2083
Phone number:
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