Individual
SOTHEAVY MOEUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 CLOUTMANS LN, MARBLEHEAD, MA 01945-1503
(781) 521-5996
Mailing address
17 CLOUTMANS LN, MARBLEHEAD, MA 01945-1503
(781) 521-5996
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11750
MA
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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