Provider Demographics
NPI:1942997705
Name:NGO, FERNANDA (RMHC)
Entity Type:Individual
Prefix:
First Name:FERNANDA
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:RMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W YALE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5949
Mailing Address - Country:US
Mailing Address - Phone:772-631-8602
Mailing Address - Fax:
Practice Address - Street 1:1971 LEE RD STE 100
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1875
Practice Address - Country:US
Practice Address - Phone:772-631-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health