Providence Sisomphou
Providence Sisomphou is a Behavior Technician in Concord, North Carolina. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
200 Branchview Dr SE Ste 215Concord, NC 28025-3577
Phone: (704) 780-4271
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1609604974 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | July 26, 2024 |
| Last updated in NPPES | July 26, 2024 |
| Certification date | July 26, 2024 |
| Mailing address | 200 Branchview Dr Se Ste 215, Concord, NC 28025-3577 |
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