Provider Demographics
NPI:1184041261
Name:WONG, JOYCE (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3438 W RED BIRD CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-5112
Mailing Address - Country:US
Mailing Address - Phone:520-333-2628
Mailing Address - Fax:
Practice Address - Street 1:240 N COURT AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-1032
Practice Address - Country:US
Practice Address - Phone:520-333-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0905171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist