MR. Andrew Keodara Phomthavong, MSW
NPI #1003110990 in Lowell, Massachusetts
Provider Information
- NPI Number
- 1003110990
- Entity Type
- Individual
- Name
- MR. Andrew Keodara Phomthavong, MSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Credential
- MSW
- Enumeration Date
- Jan 6, 2011
- Last Updated
- Jan 6, 2011
Practice Location
- Address
- 298 WALKER STREET
- City
- Lowell
- State
- Massachusetts
- ZIP Code
- 01851
- Phone
- (619) 743-9052
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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