Provider Demographics
NPI:1821247941
Name:LOUIE-WONG, JEANNE (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:LOUIE-WONG
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 GREENWAY E
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2222
Mailing Address - Country:US
Mailing Address - Phone:917-399-7821
Mailing Address - Fax:
Practice Address - Street 1:69 GREENWAY E
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2222
Practice Address - Country:US
Practice Address - Phone:917-399-7821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010854235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist