Doctor Name: | ROSE FONG |
NPI Number: | 1932362738 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW LCSW |
License Number: | 55 |
Business Practice Address: | 911 Meals Avenue Valdez, AK - 99686 |
Business Phone Number: | 9078352249 |
Business Fax Number: | 9078341890 |
Mailing Address: | Po Box 550, VALDEZ |
State: | AK |
Postal Code: | 996860550 |
Phone Number: | 9078352249 |
Fax Number: | 9078341980 |
NPI Enumeration Date: | 07/02/2008 |
NPI Last Update Date: | 07/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 55 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |