Mr. Andrew Keodara Phomthavong
Professional Counselor
298 Walker Street
Lowell
, Massachusetts 01851
Mr. Andrew Keodara Phomthavong
Professional Counselor
298 Walker Street
Lowell
, Massachusetts 01851
(619) 743-9052
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About
Features
Specialties
- Professional Counselor
Languages spoken
- English
Location
First Address
- Mr. Andrew Keodara Phomthavong
- 298 Walker St
- Lowell, MA
- Zip : 01851-1848
- Phone : (619) 743-9052
Second Address
- Mr. Andrew Keodara Phomthavong
- 298 Walker Street
- Lowell, MA
- Zip : 01851
- Phone : (619) 743-9052
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP2500X | Professional Counselor |
National Provider Identifier
| NPI | 1003110990 |
|---|---|
| Provider Name | Mr. Andrew Keodara Phomthavong |
| First Address | Lowell, MA 01851-1848 |
| Second Address | Lowell, MA 01851 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/01/2011 |
| Last Update Date | 06/01/2011 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.