Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003141300 |
---|---|
Provider Name | Ms. Phuong Ngo |
First Address | Long Beach, CA 90806-5501 |
Second Address | Long Beach, CA 90806-5501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2009 |
Last Update Date | 05/10/2009 |