Individual
SOUMONTHA MANIKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5985 RICE CREEK PKWY, SUITE 201, SHOREVIEW, MN 55126-5038
(651) 348-7240
Mailing address
5985 RICE CREEK PKWY, SUITE 201, SHOREVIEW, MN 55126-5038
(651) 348-7240
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
01781
MN
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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