Individual
SUSANNA JUN YAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
600 STEWART ST STE 300, SEATTLE, WA 98101-1257
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59203
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA61302797
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
07/21/2022
Last updated
11/14/2022
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