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General NPI Number Information
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NPI Number | 1619139607
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Entity Type | Individual
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Provider Name | NADINE SABRINA HOUSEN-WONG PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 307 N GREEN ST
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City | WADESBORO
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State | NC
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Zip | 28170-2182
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Country | US
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Telephone | 704-649-9656
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Fax |
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Provider Business Mailing Address
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Address Line | 307 N GREEN STREET
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City | WADESBORO
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State | NC
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Zip | 28170
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Country | US
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Telephone | 704-649-9656
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3461
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License Number State | NC
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