Individual
DANNI VIENGSAVAHN SUTANA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15-2734 AHOLEHOLE ST, PAHOA, HI 96778-9609
(808) 437-0581
Mailing address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(808) 437-0581
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
R10253
OR
Other
Enumeration date
08/01/2023
Last updated
10/19/2024
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