Individual
MISS PAM THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
701 E CHANNEL ST, STOCKTON, CA 95202-2628
(209) 944-4700
Mailing address
7210 MURRAY DR, STOCKTON, CA 95210-3339
(209) 373-2800
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
75808
CA
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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