Individual
ANDREW SOVANNAK PONN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
594 YANKEE BOY LOOP, ELIZABETH, CO 80107-8688
(720) 383-3419
Mailing address
594 YANKEE BOY LOOP, ELIZABETH, CO 80107-8688
(720) 383-3419
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCC.0023260
CO
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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