Provider Demographics
NPI:1063176667
Name:WONG, PUI YEE
Entity type:Individual
Prefix:
First Name:PUI YEE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 SUMMIT NORTH DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3147
Mailing Address - Country:US
Mailing Address - Phone:408-898-8928
Mailing Address - Fax:
Practice Address - Street 1:11030 JONES BRIDGE RD STE 310
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-4560
Practice Address - Country:US
Practice Address - Phone:167-869-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician