Individual
MS. MICHELE LYN KONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
302 5TH AVE # 819, NEW YORK, NY 10001-3604
(646) 881-4307
Mailing address
PO BOX 1274, LONG ISLAND CITY, NY 11101
(646) 881-4307
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
001022
NY
102L00000X
Psychoanalyst
Primary
DCATEMP-017621
NJ
Other
Enumeration date
05/10/2018
Last updated
09/09/2020
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