Provider Demographics
NPI:1972570455
Name:WONG, MARGARET M (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:M
Last Name:WONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44095 PIPELINE PLZ STE 240
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7515
Mailing Address - Country:US
Mailing Address - Phone:703-723-2999
Mailing Address - Fax:703-723-4144
Practice Address - Street 1:44095 PIPELINE PLZ STE 240
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7515
Practice Address - Country:US
Practice Address - Phone:703-723-2999
Practice Address - Fax:703-723-4144
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0803000229103TS0200X
VA0810005793103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA39227OtherWELLMARK BC/BS
IAI15484Medicare ID - Type Unspecified