Provider Demographics
NPI:1184907438
Name:AGUIRRE-WONG, NELDA (LMHC)
Entity type:Individual
Prefix:
First Name:NELDA
Middle Name:
Last Name:AGUIRRE-WONG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 S RED RD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3654
Mailing Address - Country:US
Mailing Address - Phone:305-562-9750
Mailing Address - Fax:
Practice Address - Street 1:6915 S RED RD
Practice Address - Street 2:SUITE 221
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3654
Practice Address - Country:US
Practice Address - Phone:305-562-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2498101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health