Provider Demographics
NPI:1619139607
Name:HOUSEN-WONG, NADINE SABRINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:SABRINA
Last Name:HOUSEN-WONG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 N GREEN STREET
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170
Mailing Address - Country:US
Mailing Address - Phone:704-649-9656
Mailing Address - Fax:
Practice Address - Street 1:307 N GREEN ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2182
Practice Address - Country:US
Practice Address - Phone:704-649-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3461103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist