Basic Information
| Provider Information | |||||||||
| NPI: | 1154624575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SONG | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | SUNYOUNG | ||||||||
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| Credential: | M.A. CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 SILVERSIDE RD | ||||||||
| Address2: | 3A | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198103719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024789878 | ||||||||
| FaxNumber: | 3024788069 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 SILVERSIDE RD | ||||||||
| Address2: | SUITE 3A | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198103719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024789878 | ||||||||
| FaxNumber: | 3024788069 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2010 | ||||||||
| LastUpdateDate: | 04/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 02-0000097 | DE | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.