Individual
DR. BONNIE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1842 BEACON ST STE 402, BROOKLINE, MA 02445-1922
(617) 283-9739
(888) 972-6581
Mailing address
68 SEAVERNS AVE APT A, JAMAICA PLAIN, MA 02130-3098
(617) 283-9739
(857) 972-6581
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
8414
MA
103T00000X
Psychologist
8414
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0599077
—
MA
Enumeration date
06/27/2006
Last updated
04/10/2023
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