Individual
MRS. WANNAPORN VUDHICHAMNONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
7510 CHARMANT DR APT 727, SAN DIEGO, CA 92122-5027
(512) 461-6890
Mailing address
7510 CHARMANT DR APT 727, SAN DIEGO, CA 92122-5027
(512) 461-6890
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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