Provider Demographics
NPI:1508593237
Name:WONG, SOFIA NELLY (MS)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:NELLY
Last Name:WONG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 DELERY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-1516
Mailing Address - Country:US
Mailing Address - Phone:940-627-9825
Mailing Address - Fax:
Practice Address - Street 1:302 DELERY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-1516
Practice Address - Country:US
Practice Address - Phone:940-627-9825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist