| NPI | 1770943128 |
|---|---|
| Former Name | JO SEP CHANG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC0618900) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 088968) |
| Enumeration Date | 2016-02-27 |
| Last Update Date | 2025-01-08 |