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NPI Code Detail

MEDICARE: MELISSA WONG MS, CGC

MEDICARE: MELISSA WONG MS, CGC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1170300000XGenetic Counselor (M.S.)GT61232009WA
2170300000XGenetic Counselor (M.S.)GC001488CA
3170300000XGenetic Counselor (M.S.)GEN-329ID
4170300000XGenetic Counselor (M.S.)481TN
5170300000XGenetic Counselor (M.S.)12509210-3601UT
6170300000XGenetic Counselor (M.S.)GC273FL
7170300000XGenetic Counselor (M.S.)1485MN
8170300000XGenetic Counselor (M.S.)466CT
9170300000XGenetic Counselor (M.S.)0348SD
10170300000XGenetic Counselor (M.S.)20100

General Provider Information

NPI Number : 1790427730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA WONG MS, CGC
Provider Business Mailing Address
First Line : 2677 E PARLEYS WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-1617
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2677 E PARLEYS WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-1617
Country : US
Telephone Number : 801-931-6178
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 07/27/2022

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