Individual
FIDELA BOUATHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 JESSIE AVE, SACRAMENTO, CA 95838-2609
(916) 922-7177
Mailing address
623 14TH ST, SACRAMENTO, CA 95814
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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