Individual
PORNPHUN SLAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 WINOOSKI FALLS WAY STE 400, WINOOSKI, VT 05404-2239
(802) 857-0400
Mailing address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
(818) 893-4509
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
123258
CA
106H00000X
Marriage & Family Therapist
Primary
12789279-3902
UT
Other
Enumeration date
09/14/2017
Last updated
09/07/2022
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