Individual
SOTHEANG TERRY KHIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 EAST ST, PLAINVILLE, CT 06062-2367
(860) 793-4200
Mailing address
17 BOXWOOD LN, DANBURY, CT 06811-5210
(203) 512-1279
(203) 512-1279
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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