NPI | 1467959759 |
---|---|
Former Name | WINNIE FONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6345) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810007677) |
101YM0800X Counselor, Mental Health (Licence: DC PSYA00208) | |
Enumeration Date | 2018-04-12 |
Last Update Date | 2024-03-28 |