Individual
KHANH DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 E MOELLER ST, PRESCOTT, AZ 86301-2612
(928) 420-8300
Mailing address
142 N RUSH ST APT 3, PRESCOTT, AZ 86301-3225
(773) 312-1311
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
10751
AZ
Other
Enumeration date
02/20/2021
Last updated
02/20/2021
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