Individual
EMILY GONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7935 LAKE BALLINGER WAY, EDMONDS, WA 98026-9166
(206) 717-4770
Mailing address
17829 3RD AVE SE, BOTHELL, WA 98012-9227
(425) 459-4529
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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