Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 8850 | NE |
N | 101YM0800X | Mental Health Counselor | 8850 | NE |
Y | 102L00000X | Psychologist | 4180 | AZ |
Y | 103T00000X | Psychologist | 4180 | AZ |
N | 103TA0700X | Adult Development & Aging Psychologist | 4180 | AZ |
N | 103G00000X | Clinical Psychologist | 4180 | AZ |
N | 103TC0700X | Clinical Psychologist | 4180 | AZ |
N | 103TC1900X | Counseling Psychologist | 4180 | AZ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4180 | AZ |
N | 103TF0000X | Family Psychologist | 4180 | AZ |
NPI | 1023242229 |
---|---|
Provider Name | Kuo-Yi Chung |
First Address | Mesa, AZ 85210-3056 |
Second Address | Mesa, AZ 85210-3056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2009 |
Last Update Date | 27/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
470798717-26,27-,29 | (05) | NE |
96097 | BCBS OF NEBRASKA (01) | NE |