Individual
CHANTIYA R PHARHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 WEBB DR STE 2171, DAVENPORT, FL 33837-3963
(863) 270-1339
Mailing address
131 BIRMINGHAM DR, KISSIMMEE, FL 34758-4107
(321) 314-8846
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-22-209245
FL
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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