Individual
DEIDRE - ANN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 LOWELL AVE, WATERBURY, CT 06708-1913
(347) 234-2799
Mailing address
21 LOWELL AVE, WATERBURY, CT 06708-1913
(347) 234-2799
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
103K00000X
—
Other
Enumeration date
04/24/2018
Last updated
01/31/2023
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