Individual
CHLOE VONGPHACHANH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6674
(817) 442-0222
Mailing address
2425 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6674
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7350
TX
106S00000X
Behavior Technician
20131374
TX
Other
Enumeration date
08/20/2020
Last updated
09/25/2024
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