Provider Demographics
NPI:1902995467
Name:ONG, KRISTIN N I (MA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:N
Last Name:ONG
Suffix:I
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5928 WESCOTT HILLS WAY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-4741
Mailing Address - Country:US
Mailing Address - Phone:703-425-9200
Mailing Address - Fax:703-425-9206
Practice Address - Street 1:8000 FORBES PL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2200
Practice Address - Country:US
Practice Address - Phone:703-425-9200
Practice Address - Fax:703-425-9206
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist