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Individual
SIMON NFOSAK MBONGO
Active
Individual
SIMON NFOSAK MBONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
VN211623
CA
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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