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General NPI Number Information
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NPI Number | 1245571405
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Entity Type | Individual
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Provider Name | VALERIE LEE WONG SLP-CCC
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Gender | Female
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 07/25/2014
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Provider Practice Location Address
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Address Line | 217 W CERRITOS AVE
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City | ANAHEIM
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State | CA
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Zip | 92805-6549
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Country | US
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Telephone | 714-776-1231
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Fax | 714-227-0802
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Provider Business Mailing Address
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Address Line | 12702 RED HILL AVE
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City | SANTA ANA
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State | CA
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Zip | 92705-3470
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Country | US
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Telephone | 949-689-0343
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8192
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License Number State | CA
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