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Individual
KELLY T PHAM
Active
Individual
KELLY T PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY29070
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2010
Last updated
01/22/2023
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