Provider Demographics
NPI:1174879522
Name:NG, MICHELLE LOWE (MFT)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LOWE
Last Name:NG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5861 PINE AVE STE B-6
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6540
Mailing Address - Country:US
Mailing Address - Phone:909-536-1749
Mailing Address - Fax:909-280-7985
Practice Address - Street 1:5861 PINE AVE STE B-6
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6540
Practice Address - Country:US
Practice Address - Phone:909-536-1749
Practice Address - Fax:909-280-7985
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC51893106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist