Individual
BOSSEBA KONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCS 16696
Contact information
Practice address
1100 KANSAS AVE, SUITE A, MODESTO, CA 95351-1596
(209) 558-7475
(209) 558-4042
Mailing address
1100 KANSAS AVE, SUITE A, MODESTO, CA 95351-1596
(209) 558-7475
(209) 558-4042
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1041C0700X
CA
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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