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General NPI Number Information
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NPI Number | 1093657611
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Entity Type | Individual
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Provider Name | LIAN WONG
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Gender | Female
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 107 AUDUBON RD STE 10
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City | WAKEFIELD
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State | MA
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Zip | 01880-1245
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Country | US
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Telephone | 781-245-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 43 REVERE ST UNIT 3
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City | BOSTON
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State | MA
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Zip | 02114-4307
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Country | US
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Telephone | 609-216-0891
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTL36479
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License Number State | MA
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