Individual
LINE ORNELLA FASSU SIANKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2423 WILLIAMS DR STE 105, GEORGETOWN, TX 78628-3200
(877) 800-5722
Mailing address
2423 WILLIAMS DR STE 107, GEORGETOWN, TX 78628-3269
(877) 800-5722
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
62350
TX
1835P1300X
Psychiatric Pharmacist
76080
CA
Other
Enumeration date
01/20/2017
Last updated
06/30/2025
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