Individual
MONICA PHONGSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
457 LIBERTY HWY, PUTNAM, CT 06260-2721
(860) 942-9619
Mailing address
457 LIBERTY HWY, PUTNAM, CT 06260-2721
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
32745
CA
235Z00000X
Speech-Language Pathologist
4675
CO
235Z00000X
Speech-Language Pathologist
61339861
WA
235Z00000X
Speech-Language Pathologist
6165
CT
235Z00000X
Speech-Language Pathologist
Primary
77694
MA
Other
Enumeration date
12/23/2022
Last updated
12/23/2022
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