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Individual
STEVEN CHARLES WONG
Active
Individual
STEVEN CHARLES WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
138212-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001398101
INTERMOUNTAIN HEALTH CARE
UT
01
—
261949
DESERET MUTUAL
UT
01
—
942938348003
CHAMPUS
UT
01
—
942938348W01
EDUCATORS MUTUAL
UT
Enumeration date
12/14/2005
Last updated
06/14/2012
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