Individual
DR. PORNTHIP CHALUNGSOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
525 N. GARLAND AVE., FAYETTEVILLE, AR 72701
(479) 575-5276
(479) 575-7438
Mailing address
1005 E. ROLLING HILLS DR., FAYETTEVILLE, AR 72703
(479) 582-1245
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P9307012
AR
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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