Provider Demographics
NPI:1700545001
Name:ZHONG, NICOLE HONGXUAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:HONGXUAN
Last Name:ZHONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:HONGXUAN
Other - Middle Name:
Other - Last Name:ZHONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:906 NEAL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1434
Mailing Address - Country:US
Mailing Address - Phone:434-227-8909
Mailing Address - Fax:
Practice Address - Street 1:906 NEAL DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1434
Practice Address - Country:US
Practice Address - Phone:434-227-8909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006471103TC0700X
MD06773103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical