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1356418859
GLEN WONG
WAIANAE, HI
NPI
1356418859
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2006-11-29
Last Update Date
2007-07-08
Business Address
-- GLEN WONG csac
86-226 FARRINGTON HIGHWAY
WAIANAE, HI 96792-3128
Phone number: 808-696-4211
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Mailing Address
-- GLEN WONG csac
86-226 FARRINGTON HWY
WAIANAE, HI 96792-3128
Phone number: 808-696-4211
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