Individual
MS. BARBARA R WONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
7434 S STATE ST, MIDVALE, UT 84047-2014
(801) 566-4423
(801) 566-4779
Mailing address
1140 E 2700 S, UNIT L93, SALT LAKE CITY, UT 84106-2634
(801) 463-7714
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
2105563102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107030192101
U006
UT
01
—
2621333
U002
UT
Enumeration date
01/30/2006
Last updated
07/08/2007
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