Individual
KAREN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1604 FORD AVE, MODESTO, CA 95350-4631
(209) 840-1624
Mailing address
2720 PALAZZO CT, MODESTO, CA 95356-9336
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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