Individual
DR. WING MAN FONG
Active
Individual
DR. WING MAN FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2017002012
MO
103TC0700X
Clinical Psychologist
Primary
071-010809
IL
103TC1900X
Counseling Psychologist
2017002012
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490087956
—
MO
Enumeration date
09/24/2010
Last updated
08/23/2023
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