Provider Demographics
NPI:1154624575
Name:SONG, MONICA SUNYOUNG (MA CCC-A)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:SUNYOUNG
Last Name:SONG
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 SILVERSIDE RD
Mailing Address - Street 2:3A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3719
Mailing Address - Country:US
Mailing Address - Phone:302-478-9878
Mailing Address - Fax:302-478-8069
Practice Address - Street 1:2700 SILVERSIDE RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3719
Practice Address - Country:US
Practice Address - Phone:302-478-9878
Practice Address - Fax:302-478-8069
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE02-0000097231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist