Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1974 | KS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1974 | KS |
Y | 103G00000X | Clinical Psychologist | 1974 | KS |
Y | 103TC0700X | Clinical Psychologist | 1974 | KS |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1974 | KS |
N | 103TF0000X | Family Psychologist | 1974 | KS |
N | 103TP2701X | Group Psychotherapist | 1974 | KS |
NPI | 1275834533 |
---|---|
Provider Name | Dr. Victor Howard Wong JR. |
First Address | Pittsburgh, PA 15206-1206 |
Second Address | Pittsburgh, PA 15206-1206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2010 |
Last Update Date | 26/07/2011 |