Individual
DR. IVY CHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
150 W UNIVERSITY BLVD, SCOTT CENTER FOR AUTISM TREATMENT, MELBOURNE, FL 32901-6982
(321) 674-8615
(321) 674-8411
Mailing address
150 W UNIVERSITY BLVD, SCOTT CENTER FOR AUTISM TREATMENT, MELBOURNE, FL 32901-6982
(321) 674-8615
(321) 674-8411
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-04-1585
FL
103T00000X
Psychologist
Primary
8214
FL
103TC2200X
Clinical Child & Adolescent Psychologist
6301012869
MI
Other
Enumeration date
09/27/2007
Last updated
07/11/2011
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