Healthcare Provider Details

I. General information

NPI: 1457271793
Provider Name (Legal Business Name): NAPORN WONGMUANGKAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATRINA WONGMUANGKAN

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7915 EASTERN AVE APT 514
SILVER SPRING MD
20910-5800
US

IV. Provider business mailing address

7915 EASTERN AVE APT 514
SILVER SPRING MD
20910-5800
US

V. Phone/Fax

Practice location:
  • Phone: 832-879-3060
  • Fax:
Mailing address:
  • Phone: 832-879-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberA01176
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: