Provider Demographics
NPI:1548476443
Name:WONG, SHAU-JWO (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHAU-JWO
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 POKI ST
Mailing Address - Street 2:APARTMENT 401
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3286
Mailing Address - Country:US
Mailing Address - Phone:808-951-7478
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-8230
Practice Address - Fax:808-983-6752
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist