Individual
SOVANNIMUL BOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
439 S UNION ST, LAWRENCE, MA 01843-2837
(978) 681-9652
Mailing address
439 S UNION ST # 207A, LAWRENCE, MA 01843-2837
(978) 681-9652
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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