Individual
MRS. KHOA NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2823 GLENWOOD AVE, ROCKFORD, IL 61101-3507
(815) 968-5342
(815) 968-4656
Mailing address
2823 GLENWOOD AVE, ROCKFORD, IL 61101-3507
(815) 968-5342
(815) 968-4656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180010755
IL
101YP2500X
Professional Counselor
2014022243
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13549065
CAQH
—
Enumeration date
09/03/2014
Last updated
04/05/2017
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